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Fannie Castignoles; New set of complementary extended-depth-of-focus IOL: comparison with the state-of-the-art.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3711.
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To compare the through-focus optical quality of two new complementary extended-depth-of-focus IOLs with a state-of-the-art trifocal and EDOF ones.
Three IOLs are under study: ARTIS ACTIVE MID (favouring intermediate range) and PLUS (favouring near vision range) (Cristalens Industrie, France) are two new diffractive complementary IOLs, with extended depth of focus that were designed to benefit from binocularity. FineVision (Physiol, Belgium) is a trifocal IOL with +1.75D/+3.5D focal points. The Symfony (AMO, USA) is also an extended-depth-of-focus IOL.The through-focus modulation transfer function (TF-MTFs) at 50 cycle/mm from +1D to -4D, are compared in silico (Zemax, USA) and on optical bench (Trioptics, Germany). We applied the strong linear relationship between 1/MTFa (averaged TF-MTF) and clinical defocus curves demonstrated by Alarcon to four diffractive IOLs, to simulate the defocus curves with those 4 IOLs.
We found good agreement between simulation and optical bench measurements. The four IOLs have similar peak heights for distance vision in the TF-MTF, with very little higher energy for the ARTIS ACTIVE PLUS. FineVision presented the well-known pattern with two other narrow peaks on TF-MTF at 1.75D and 3.5D, Symfony was providing a bifocal through-focus MTF with 1.75D addition, while ARTIS ACTIVE MID demonstrated a broad peak with a maximum on 1.8D, with height higher than 0.15 towards 2.5D and ARTIS ACTIVE PLUS had a broad peak, with height higher than 0.15 from 2D to 3.5D. ARTIS ACTIVE MID and Symfony demonstrated better simulated visual acuity from -0.5D to 2D than FineVision and ARTIS ACTIVE PLUS. ACTIVE PLUS was higher than ACTIVE MID, Symfony from 2D to 3D..Combination of ARTIS ACTIVE MID with PLUS complementary IOLs provides a continuum of MTF higher than 0.15 from 1.5D to 3.5D (in the lenticular plane).
Although the TF-MTF is only relevant of the contrast, it is admitted that MTF higher than 0.15 is relevant of functional visual acuity. With complementary implantation of ARTIS ACTIVE MID and PLUS, patients should benefit of continuous sharp vision from infinity to 35 cm, with no need for adapting the object distance to the best focus, which would be an incremental but significant improvement to the state-of-the-art.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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