SimVis simulations of multifocal IOL designs based on public-literature data

Abstract

As a large variety of intraocular lens (IOL) designs is commercially available in a growing market, selecting the best IOL for each patient has become a crucial task for a positive surgical outcome. Information about the measured or estimated performance of commercial lenses, as the through-focus modulation transfer function (TF-MTF) at a given frequency and pupil diameter, is routinely published. SimVis Gekko, a see-through simultaneous vision simulator based on temporal multiplexing, allows patients to experience the real world through different multifocal corrections prior to surgery. Implementing the maximum number of commercially available IOL designs into the portfolio of SimVis Gekko simulations is needed to provide a complete experience for the patients. We developed a new method to visually simulate IOL designs using temporal multiplexing, based only on publicly available information (mainly scientific literature or regulatory information), using the TF-MTF at 15cpd as input data to estimate the temporal coefficients that provide the best approximation to the real lens design. We validated the method with synthetic phase maps of equal area segmented bifocal and trifocal multifocal corrections for three pupil diameters of 3mm, 3.75mm and 4.5mm and applied it to three commercially available IOLs (trifocal or extended-depth-of-focus lenses). Through-focus visual acuity (TF-VA) curves were measured in seven patients using the SimVis simulations in the SimVis Gekko and matched, on average, the through-focus VA measurements in patients with implanted IOLs, reported in the scientific literature (on average logMAR RMS error=0.05, corresponding to less than 3 letters of visual acuity charts).