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Optical and predicted visual performance of multifocal and extended depth of focus designs

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Posterboard#: A0500

Abstract Number: 581 - A0500

AuthorBlock: Mihai State1, Carmen Canovas1, Miguel Faria-Ribeiro1, Guillermo Perez1, Patricia Piers1
1Research & Development, AMO Groningen B.V., Groningen, Netherlands;

DisclosureBlock: Mihai State, AMO Groningen B.V., Netherlands Code E (Employment), Carmen Canovas, AMO Groningen B.V., Netherlands Code E (Employment), Miguel Faria-Ribeiro, Faria Ribeiro, Miguel [VISEU] Code E (Employment), Guillermo Perez, GPerez44@its.jnj.com Code E (Employment), Patricia Piers, AMO Groningen B.V., Netherlands Code E (Employment)

Purpose
Multifocal (MF) intraocular lenses (IOLs) are designed to address presbyopia at the time of cataract surgery. Although MF technologies were originally bifocal, MF IOLs with additional foci have become recently available. Extended depth of focus (EDOF) designs are an alternative to MF technologies. While MF IOLs have distinct add power(s) and create distinct foci(s), EDOF IOLs are designed to effectively extend the range of vision. The purpose of this study is to compare the optical and the predicted visual performances of different MF and EDOF technologies.

Methods
Preclinical testing was performed under clinically relevant conditions for three different IOL designs: two MF, one bifocal with +2.75D add power and a trifocal IOL, with +2.17D and +3.25D add power (in the IOL plane), as well as a next generation EDOF designed to extend the range of vision up to +2.50D (in the spectacle plane). Through focus and frequency modulation transfer function (MTF) was measured in white light for 3 and 5mm pupil’s diameters in an eye model that reproduces average corneal spherical aberration. Binocular simulated visual acuity (VA) was calculated from the area under the MTF (MTFa) up to 50 cycles per mm.

Results
For distance, MTFa was highest for the next generation EDOF IOL for both pupil sizes evaluated. Distance MTFa was comparable for the MF designs at 3mm pupil, approximately 20% worse than the EDOF IOL. For the larger pupil, MTFa was reduced by 27% and 41% for the bifocal and trifocal MF IOLs as compared to the EDOF. Simulated VA at distance and near was comparable for all IOL designs, with less than 0.5 lines of difference. While at distance the EDOF IOL provided better performance, the trifocal IOL was better at near. The biggest differences were in the intermediate range where the EDOF design provided the highest VA, 0.02LogMAR, followed by the bifocal and trifocal IOLs with 0.5 line and 1line difference respectively.

Conclusions
The optical and predicted visual performances of two MF IOLs and one next generation EDOF IOL were measured and compared under clinically relevant conditions. This study shows that MF technologies reduced distance image quality, especially for big pupil sizes and when additional foci are included, while the next generation EDOF IOL provided superior distance image quality at both pupil sizes and intermediate performance with comparable near vision.

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