July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Metric for assessing the functional range of vision of multifocal IOLs
Author Affiliations & Notes
  • Jim Schwiegerling
    Optical Sciences, University of Arizona, Tucson, Arizona, United States
  • Ruth Lapid-Gortzak
    Ophthalmology, Academic Medical Center, Amsterdam, Netherlands
  • Chandra Balachandran
    Macquarie University, New South Wales, Australia
  • Rajaraman Suryakumar
    Alcon Laboratories, Texas, United States
  • Footnotes
    Commercial Relationships   Jim Schwiegerling, Alcon Laboratories (F); Ruth Lapid-Gortzak, Alcon Laboratories (C); Chandra Balachandran, Alcon Laboratories (C); Rajaraman Suryakumar, Alcon Laboratories (E)
  • Footnotes
    Support  Alcon Research
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3710. doi:
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      Jim Schwiegerling, Ruth Lapid-Gortzak, Chandra Balachandran, Rajaraman Suryakumar; Metric for assessing the functional range of vision of multifocal IOLs. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3710.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To develop a new metric for determining the functional range of vision of multifocal intraocular lenses (IOLs)

Methods : Defocus curves are traditionally used to define the performance of multifocal IOLs. However, these curves tell an incomplete story regarding the functional range of vision for real world targets. To better quantify the useful functional range of vision for physiologically relevant acuity demands, the defocus curve was overlaid with the visual acuity demand for a target size equivalent that varied as a function of defocus. For example, a typical text message on a cell phone screen has an acuity demand of 20/20 at a distance of 1m (1D), but the acuity demand reduces to 20/40 at a distance of 0.5m (2D). By overlaying the acuity demand onto the defocus curve a measure of acuity reserve can be determined for all target distances. An area under the curve (AUC) metric was developed to estimate the useful functional range of acuity reserve between 1m (1D) and 40 cm (2.5D) by integrating the region between the acuity demand curve and the defocus curve. The metric was applied to data obtained from a study whose subjects were implanted bilaterally with the Alcon PanOptix IOL (Model TFNT00). Binocular defocus curves for a range of +2.0D to -5.0D of induced defocus was measured at the 4-6 month follow up visit. A target with a visual acuity demand equivalent to 0.1 LogMAR (20/25) was used to determine the AUC metric for each subject.

Results : A total of 167 patients were enrolled in the study and 145 patients completed the follow up visits per the study protocol. The AUC metric showed mean overall area of 0.38 ± 0.11 between 1m (1D) and 40cm(2.5D). The comparison between acuity demand and defocus curve performance revealed that PanOptix showed approximately 3-4 lines of functional acuity reserve at intermediate (1.5D) and near (2.5D) distances.

Conclusions : The AUC metric may be a useful tool to understand acuity reserve to changing visual demands for real-world targets as a function of optical defocus/distance. The PanOptix IOL provides a clinically significant functional acuity reserve at intermediate and near distances.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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