Abstract
Purpose :
On-bench evaluation of real multifocal intraocular lenses allows testing different designs and conditions before its manufacturing or implantation in real patients. We evaluated through focus (TF) optical and visual quality of various multifocal lens designs in a new channel of a polychromatic adaptive optics (AO) visual simulator that allows projecting the physical lens on the patient’s eye
Methods :
A polychromatic custom-built AO visual simulator was expanded to incorporate a new channel for projection of real IOLs to allow vision through them prior to implantation. The system consisted on a Rassow lens system (4F relay configuration) and a cuvette with the IOL on a conjugate pupil plane. 5 monofocal IOLs (18-23D) were used for validation. 3 commercial IOLs from PhysIOL (Podeye aspheric monofocal, AsMo; Isofocal extended depth-of-focus, EDOF & Finevision diffractive trifocal, Tri) ) were tested with the cuvette.TF images of 20/20 E-optotype displayed on a DLP projector (555 nm) were collected on the CCD camera acting as retina of an artificial eye.A deformable mirror (DM) allowed to induce spherical aberration (SA:+0.2 um), mimicking the cornea. Image correlations were used as an optical quality metric. TF visual acuity (VA) was also obtained on 2 cyclopleged patients for the 3 IOLs, using an 8-Alternative Forced Choice with tumbling E letters. Optical and Visual TF curves (for 6mm pupils) were compared using a correlation analysis. DOF was calculated as the dioptric range with VA>0.5
Results :
The new IOL-in-cuvette channel allows compensation of IOLs power from 16 to 23D in coordination with a linear displacement of the Badal system (0.75 mm/D; p<0.01).Optical quality was 0.96/0.89/0.95 at far (F), 0.76/0.78/0.77 at intermediate (I:+1.75D) and 0.62/0.72/0.77 at near (N:+3.50D) for AsMo/EDOF/Tri respectively. Induction of SA with a DM reduced optical quality at N by 2.9% with AsMo, and 3.9% with Tri, but did not produce significant changes at F. Average VA was 0.85/0.8/0.86(F), 0.4/0.48/0.65(I), 0.21/0.52/0.31(N); DOF was 2.65/3.1/4.35D for AsMo/EDOF/Tri respectively. Optical and Visual TF curves paralleled with a correlation r=0.88,p<0.01 across lenses in a 5D range
Conclusions :
An IOL-in-cuvette channel in an AO device provides an alternative channel for pre-operative simulation of IOLs and it serves for cross-validation with other programmable simulating methods (DM, SLM or SimVis) of IOLs
This is a 2020 ARVO Annual Meeting abstract.