Extended Depth Of Field Research Articles

Beam-Shaping Extended Depth of Focus Intraocular Lens: Optical Assessment With Corneas of Increasing Spherical Aberration.

To assess the optical quality and halo formation of a beam-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) (AcrySof IQ Vivity; Alcon Laboratories, Inc) with corneas of long-range spherical aberration (SA) such as those resulting from myopic laser ablations. The optical quality of the EDOF IOL and a reference monofocal IOL was evaluated with three corneas (A, B, and C, with SA =+0.135, +0.290, +0.540 µm, respectively, for a 5.15-mm pupil at the IOL plane). The through-focus modulation transfer function area (MTFa) curves were obtained between -5.00 and +2.00 diopters (D) defocus range. The halo was also assessed with the three corneas. Through-focus MTFa curves for a 4.5-mm IOL pupil showed a slight decrease in the maximum MTFa value provided by the EDOF IOL compared to the monofocal IOL in the three corneal situations (A: 45.9 vs 38.6 units; B: 41.1 vs 33.1 units, and C: 26.9 vs 23.8 units). For the 3.0-mm pupil, the EDOF IOL also had lower maximum MTFa than the monofocal IOL; however, the depth-of-focus increased to -2.20 D. With corneas A and B, the halo induced was of low energy with both IOLs. With cornea C, the EDOF IOL created a much larger and intense halo. The EDOF IOL provided a good distance optical performance and an extended range of focus of approximately 2.00 D, with a halo of low intensity when evaluated with a corneal SA similar to the one induced by a low to moderate myopic ablation. With a high myopic ablation, the halo induced would be of considerable size and energy. [J Refact Surg. 2023;39(2):95-102.].

Tight Focus Vector Light Field of Hybrid Double Circularly Polarized Beams

Based on the Richard-Wolf diffraction theory, we demonstrate the tightly focused optical field distribution with two beams circularly polarized light. We deduced the expression of the double-beam superimposed vortex light intensity of left-handed circularly polarized light and right-handed circularly polarized light under the focusing condition of a high numerical aperture objective lens. Based on the different vortex topological charge values, amplitudes and initial phases of the dual beams, we numerically simulated the light intensity distribution of the superimposed hybrid focused light field. It is found that a variety of peculiar vortex spots can be obtained through the tight focus stacking of the double beams. These complex hybrid focused light fields with different polarizations can be used in fields such as optical field micro-manipulation or nonlinear fluorescence microscopy imaging.

Design and Optical Analysis of a Refractive Aspheric Intraocular Lens with Extended Depth of Focus

To obtain a continuous range of clear vision for pseudophakic eyes, a design of intraocular lens (IOL) with extended depth of focus (EDoF) was proposed. The IOL was optimized with a multi-configuration approach based on a pseudophakic eye model and the optical performances of the designed IOL were analyzed. The modulation transfer function (MTF) values remain above 0.2 at 50 lp/mm for object distance ranging from 0.35 m to infinity in both photopic vision and mesopic vision over a field of 4°. The optical performances remain stable when the pupil diameter changes from 2.25 mm to 5 mm. Besides, the presented theoretical analyses show the designed IOL has good optical performances for polychromatic light and corneal asphericity. The above shows that the IOL exhibits an excellent ability for pseudophakic eyes to see the object in a continuous range of distance.

A digital microfluidic single-cell manipulation system optimized by extending-depth-of-field device

Microfluidic systems have been widely utilized in high-throughput biology analysis, but the difficulties in liquid manipulation and cell cultivation limit its application. This work has developed a new digital microfluidic (DMF) system for on-demand droplet control. By adopting an extending-depth-of-field (EDoF) phase modulator to the optical system, the entire depth of the microfluidic channel can be covered in one image without any refocusing process, ensuring that 95% of the particles in the droplet are captured within three shots together with shaking processes. With this system, suspension droplets are generated and droplets containing only one yeast cell can be recognized, then each single cell is cultured in the array of the chip. By observing their growth in cell numbers and the green fluorescence protein (GFP) production via fluorescence imaging, the single cell with the highest production can be identified. The results have proved the heterogeneity of yeast cells, and showed that the combined system can be applied for rapid single-cell sorting, cultivation, and analysis.

Clinical outcomes of presbyopia-correcting intraocular lenses in patients with Fuchs endothelial corneal dystrophy

Fuchs endothelial corneal dystrophy (FECD) is considered a contraindication for the implantation of presbyopia-correcting IOLs, without sufficient corroborating evidence. A Retrospective, case–control study. Nineteen eyes of ten patients with grade 2–5 FECD (study group) and 57 healthy eyes of 57 patients (control group) who underwent cataract surgery with implantation of presbyopia-correcting IOLs, at the Ein-Tal Eye Center, Tel Aviv, Israel, were included. The target refraction was emmetropia for both groups. Two subgroups of IOLs were analyzed separately: extended depth of focus (EDOF), (9 eyes of FECD patients and 27 eyes of control patients) and multifocal IOLs (10 eyes of FECD patients and 30 eyes of control patients). Main outcome measures were visual acuity and refraction 6 weeks after the surgery. Secondary outcomes were patient perceptions of visual acuity, spectacle independence, photic phenomena and satisfaction scores, reported in a self-assessment questionnaire. FECD patients in the EDOF IOL subgroup had inferior uncorrected distance visual acuity (P = 0.007) and better uncorrected near visual acuity (P = 0.001) compared to the controls. They had less spectacle independence for the intermediate range (P = 0.01) and overall (P = 0.006). However, they did not have more photic phenomena. In the multifocal IOL subgroup, no significant differences were found between the FECD and the control group in visual acuity for all ranges and in spectacle independence. FECD patients had more photic phenomena than the controls (P = 0.006), but it did not interfere with daily life activities. There was no difference in post-operative mean spherical equivalent, patient reported visual perception, and general satisfaction between FECD and control patients in both groups. Our results suggest that presbyopia-correcting IOLs can be carefully considered in patients with grade 2–5 FECD, with slightly inferior results compared with healthy eyes.

Hybrid diffractive optics (DOE & refractive lens) for broadband EDoF imaging

In the considered hybrid diffractive imaging system, a refractive lens is arranged simultaneously with a multilevel phase mask (MPM) as a diffractive optical element (DOE) for Achromatic Extended-depth-of-field (EDoF) imaging. This paper proposes a fully differentiable image formation model that uses neural network techniques to maximize the imaging quality by optimizing MPM, digital image reconstruction algorithm, refractive lens parameters (aperture size, focal length), and distance between the MPM and sensor. Firstly, model-based numerical simulations and end-to-end joint optimization of imaging are used. A spatial light modulator (SLM) is employed in the second stage of the design to implement MPM optimized at the first stage, and the image processing is optimized experimentally using a learning-based approach. The third stage of optimization is targeted at joint optimization of the SLM phase pattern and image reconstruction algorithm in the hardware-in-the-loop (HIL) setup, which allows compensation for a mismatch between numerical modeling and the physical reality of optic and sensor. A comparative analysis of the imaging accuracy and quality using the optical parameters is presented. It is proved experimentally, first time to the best of our knowledge, that wavefront phase modulation can provide imaging of advanced quality as compared with some commercial multi-lens cameras.

Peripheral Refraction of Two Myopia Control Contact Lens Models in a Young Myopic Population.

Peripheral refraction can lead to the development of myopia. The aim of this study was to compare relative peripheral refraction (RPR) in the same cohort of uncorrected (WCL) and corrected eyes with two different soft contact lenses (CL) designed for myopia control, and to analyze RPR depending on the patient’s refraction. A total of 228 myopic eyes (114 healthy adult subjects) (−0.25 D to −10.00 D) were included. Open-field autorefraction was used to measure on- and off- axis refractions when uncorrected and corrected with the two CLs (dual focus (DF) and extended depth of focus (EDOF)). The RPR was measured every 10° out to 30° in a temporal-nasal orientation and analyzed as a component of the power vector (M). The average RPR for all subjects was hyperopic when WCL and when corrected with EDOF CL design, but changed to a myopic RPR when corrected with DF design. Significant differences were found between RPR curves with both CLs in all the eccentricities (Bonferroni correction p < 0.008, except 10°N). An incremental relationship between relative peripheral refraction at 30 degrees and myopia level was found. It is concluded that the two CLs work differently at the periphery in order to achieve myopia control.

Rethinking low-cost microscopy workflow: Image enhancement using deep based Extended Depth of Field methods

Microscopic techniques in low-to-middle income countries are constrained by the lack of adequate equipment and trained operators. Since light microscopy delivers crucial methods for the diagnosis and screening of numerous diseases, several efforts have been made by the scientific community to develop low-cost devices such as 3D-printed portable microscopes. Nevertheless, these devices present some drawbacks that directly affect image quality: the capture of the samples is done via mobile phones; more affordable lenses are usually used, leading to poorer physical properties and images with lower depth of field; misalignments in the microscopic set-up regarding optical, mechanical, and illumination components are frequent, causing image distortions such as chromatic aberrations. This work investigates several pre-processing methods to tackle the presented issues and proposed a new workflow for low-cost microscopy. Additionally, two new deep learning models based on Convolutional Neural Networks are also proposed (EDoF-CNN-Fast and EDoF-CNN-Pairwise) to generate Extended Depth of Field (EDoF) images, and compared against state-of-the-art approaches. The models were tested using two different datasets of cytology microscopic images: public Cervix93 and a new dataset that has been made publicly available containing images captured with μSmartScope. Experimental results demonstrate that the proposed workflow can achieve state-of-the-art performance when generating EDoF images from low-cost microscopes.

Extended depth of focus intraocular lens versus a new monofocal intraocular lens: A prospective comparative and interventional study.

To compare the visual outcome findings between a new monofocal intraocular lens (IOL) (Tecnis Eyhance) and extended depth of focus (EDOF) IOL (Appasamy Supraphob Infocus). This prospective comparative interventional study evaluated 31 patients after implantation of Tecnis Eyhance (15 patients) and Supraphob EDOF IOL (16 patients). The uncorrected and corrected distance and intermediate and near visual acuity were measured at postoperative day 1, 1 week, 4 week, and 3 months. Contrast sensitivity, incidence of halos and glares, and patient satisfaction were assessed at 3 months postoperatively. The Tecnis Eyhance (n = 15) and Supraphob EDOF (n = 16) group were comparable with respect to all preoperative parameters including biometry, visual acuity, and cataract status. The average age distribution of participants was 56 ± 6 years. Postoperatively, both groups had similar distance and intermediate vision, but the near vision was significantly better in the EDOF group (P < 0.01) as compared to Tecnis Eyhance at 3 months. The contrast sensitivity and patient satisfaction were similar in both the groups. The incidence of halos and glares was present in the EDOF group, but it was statistically insignificant. The Tecnis Eyhance and Supraphob EDOF both were effective in improving distance and intermediate vision, but the near vision was significantly better in the EDOF group. Both the groups retained good contrast sensitivity and the majority of patients were satisfied.

Latest Development in Extended Depth-of-Focus Intraocular Lenses: An Update.

In recent years, there has been an overwhelming influx of different types of intraocular lenses (IOLs) as treatment for presbyopia. The extended depth-of-focus (EDOF) technology creates a single elongated focal point to enhance depth of focus, in contrast to the multiple foci of multifocal (MF) lenses. In this way, the EDOF lenses aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage of this is a blur due to decreased retinal image quality when the amount of the aberrations is increased excessively. Multifocality and EDOF characteristics are not exclusive of each other. Frequently, EDOF IOLs are combined with MF optical designs, a bifocal IOL may exhibit EDOF characteristics, likewise an aspheric monofocal IOL or a diffractive or refractive trifocal IOL. Thus, EDOF lenses are commonly subjected to confusion. A wide range of different types of EDOF lenses are available on the market to surgeons. In this practical update, we aim to clarify what is a true EDOF lens, classify the different types of the EDOF lenses based on their optical principle and review their recently reported outcomes. Comprehensive patient examination and selection, combined with knowledge of the most updated options and adequate patient counseling, can avoid dissatisfaction and yield the desired outcomes.

Clinical Outcomes with Extended Depth of Focus Intraocular Lenses in Cases in Which Multifocal Lenses Are Not Primarily Recommended.

The purpose of the study is to evaluate the visual and patient-reported outcomes of patients undergoing cataract surgery with implantation of an extended depth of focus (EDOF) intraocular lens (IOL) who were not primarily good candidates for multifocal IOL implantation. Retrospective analysis of data from 30 eyes (23 patients) undergoing cataract surgery with implantation of one of two EDOF IOLs (follow-up: 37.9 ± 16.2 months) and prospective observational study including 106 eyes (78 patients) implanted with one of 6 different EDOF models (follow-up: 8.0 ± 7.7 months). Patients recruited had one of the following conditions: monofocal IOL implanted in the fellow eye, previous corneal refractive surgery, mild and nonprogressive maculopathy or glaucoma, age > 75 years, amblyopia, or previous vitrectomy. In the retrospective phase, significant improvements were found in uncorrected distance (UDVA), corrected distance (CDVA), and corrected near visual acuity (CNVA) (p ≤ 0.013), with a nonsignificant trend to improvement in uncorrected near visual acuity (UNVA). A total of 90% of patients were completely to moderately satisfied with the outcome achieved. In the prospective phase, significant improvements were found in UDVA, CDVA, UNVA, and CNVA (p ≤ 0.032), with a total of 85.5% of patients being completely to moderately satisfied (dissatisfaction 3.3%). In both phases, extreme difficulties were only reported by a limited percentage of patients for performing some near vision activities. EDOF IOLs seem to be a viable option for providing an efficient visual rehabilitation with good levels of patient satisfaction and spectacle independence associated in patients that are not primarily good candidates for multifocal IOL implantation.

Visual Performance of Eyes with Residual Refractive Errors after Implantation of an Extended Vision Intraocular Lens.

To analyze the tolerance on distance vision of different combined residual astigmatic situations in patients implanted with a novel wavefront shaping extended depth of focus (EDoF) intraocular lens (IOL). The study included patients implanted with the Acrysof® IQ Vivity® IOL. Uncorrected (UDVA) and corrected distance visual acuity (CDVA) were measured three months after surgery, considering CDVA as the reference situation of the study. Distance VA was also measured in different refractive situations: (A) with 0.50 diopters (D) of positive (myopization) and negative (hyperopization) defocus and (B) with a residual mixed astigmatic refraction induced by adding a combination of -0.25 D spherical and 0.50 D cylindrical lenses placed in vertical (against the rule-ATR), oblique, and horizontal (with the rule-WTR) positions. The study included 30 eyes of 30 patients. UDVA and CDVA were -0.04 ± 0.05 and -0.05 ± 0.05 logMAR, respectively. VA values with +0.50 D and -0.50 D of defocus were 0.01 ± 0.06 and 0.00 ± 0.04 logMAR, respectively. VA was better with distance correction (p < 0.001) and no differences were found between the myopic and the hyperopic situations (p=0.09). Distance VA for the ATR, oblique, and WTR astigmatic situations was 0.01 ± 0.05, 0.01 ± 0.06, and 0.01 ± 0.04 logMAR, respectively. VA was better for the reference situation (p < 0.001) and no differences were found among the three astigmatic situations (p=0.21). Low residual defocus and mixed astigmatic errors, regardless of its orientation, seem to be tolerated by patients implanted with the studied EDoF IOL. This trial is registered with NCT05392998. Registered 26 May 2022-Retrospectively registered.

Evaluation of extended depth-of-focus hydrophobic intraocular lens with an optic concept based on combination of high-order aberrations.

Extended depth-of-focus (EDOF) intraocular lenses (IOLs) provide a continuous range of uncorrected vision at different distances. To assess visual acuity, refractive outcomes, and patient satisfaction after cataract surgery using the LuxSmart EDOF IOL (Bausch+Lomb). A two-center, prospective observational clinical study. This study includes patients who have undergone bilateral phacoemulsification with bilateral implantation of the LuxSmart EDOF IOL, with the aim of achieving emmetropia. Visual acuity (VA) and subjective refraction were obtained in all patients preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively. Subjective measures were obtained using the Catquest-9SF questionnaire and the Patient-Reported Spectacle Independence Questionnaire (PRSIQ). Contrast sensitivity and a glare assessment were undertaken postoperatively. Safety outcomes were additionally assessed. Sixty eyes from thirty patients were recruited for this study. The mean spherical equivalent was 1.04 ± 1.67 D preoperatively and -0.30 ± 0.46 D at 6 months. Monocular uncorrected distance VA was 0.57 ± 0.32 (logMAR) preoperatively and 0.09 ± 0.12 (logMAR) at 6 months. Mean 6-month monocular uncorrected VA was 0.11 ± 0.13, 0.12 ± 0.15, and 0.31 ± 0.15 (logMAR) at 80, 66, and 40 cm, respectively. More than 90% of patients were either fairly or very satisfied with their vision. There was one case of suspected vitreomacular traction postoperatively. The LuxSmart EDOF IOL offers good refractive, VA, and safety outcomes. The single elongated focal point designed to enhance the DOF shows good results for VA and patient satisfaction.

Implantation of diffractive extended depth-of-focus intraocular lenses in normal tension glaucoma eyes: A case series

PurposeImplantation of presbyopia-correcting intraocular lenses (IOLs) has not been advised for glaucomatous eyes because of the risk of decreased contrast sensitivity with progress of glaucoma. Extended depth-of-focus (EDF) IOLs have been reported to provide comparable postoperative visual function and influence on the visual field to monofocal IOLs. MethodsThis case series was a retrospective medical record review of 16 eyes of 10 patients who had normal tension glaucoma (NTG) with no central visual field defects and underwent cataract surgery with implantation of diffractive EDF IOLs. At 3 months postoperatively, distance-corrected visual acuities (DCVAs) at distances of 5, 1, and 0.5 m and photopic contrast sensitivity were examined. Automated perimetry using the 30-2 Swedish interactive threshold algorithm was also performed, and the mean variance (MD) values, mean deviation values at the central four points (central MD), and foveal threshold were recorded. ResultsThe mean age of the patients (5 men, 5 women) was 66.5 years. Over 80% of eyes obtained DCVAs of 20/20, 20/20, and 20/25 at 5 m, 1 m, and 0.5 m, respectively. Whereas 5 of 16 eyes were categorized as severe by the Hodapp-Parrish-Anderson classification, postoperative contrast sensitivity was within the normal range, except for 4 eyes at 18 cycles per degree. Conclusions and importanceIn this case series, the postoperative visual functions of NTG patients with EDF IOLs were almost comparable to those of normal eyes with the same IOLs, which demonstrated that the use of EDF IOLs for controlled NTG eyes would be permissible. While careful patient selection and follow-up for NTG progress are important, further investigations are necessary for confirming the safety and exploring the selection criteria.

Comparative Visual Outcome Analysis of a Diffractive Multifocal Intraocular Lens and a New Diffractive Multifocal Lens with Extended Depth of Focus.

This study compares the visual and refractive performance of the TECNIS Synergy (DFR00V-DFW150-225-300-375) multifocal intraocular lens (IOL) and the AcrySof IQ PanOptix (TFAT00-30-40-50-60) multifocal IOL. Patients who underwent phacoemulsification and cataract extraction and received either a multifocal Synergy or PanOptix IOL were included. Monocular uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance (CDVA) visual acuities were assessed at three and six months postoperatively. Secondary outcome measures of photic phenomena were also assessed. A total of 140 patients (224 eyes) were included in this study, with 69 patients (105 eyes) in the Synergy group and 71 patients (119 eyes) in the PanOptix group. There were no statistically significant differences in UIVA or CDVA measurements across all time points. When assessing UDVA, at three months postoperatively, there were more eyes in the PanOptix group with vision better than 20/40 (p = 0.04). At three and six months postoperatively, the average UNVA was superior in the Synergy group (p = 0.01, 0.002). While the Synergy group reported more night vision disturbances at one and three months (p = 0.01, 0.03), the PanOptix group had more night vision disturbances at six months (p = 0.02). Although not statistically significant, the AcrySof IQ PanOptix multifocal IOL demonstrated better UDVA and UIVA sooner postoperatively than the TECNIS Synergy multifocal IOL. The Synergy IOL provided statistically better UNVA compared to the PanOptix IOL at three and six months postoperatively. Synergy patients reported more early photic phenomena than PanOptix patients, which later diminished.

Phototank setup and focus stack imaging method for reptile and amphibian specimens (Amphibia, Reptilia).

Fluid-preserved reptile and amphibian specimens are challenging to photograph with traditional methods due to their complex three-dimensional forms and reflective surfaces when removed from solution. An effective approach to counteract these issues involves combining focus stack photography with the use of a photo immersion tank. Imaging specimens beneath a layer of preservative fluid eliminates glare and risk of specimen desiccation, while focus stacking produces sharp detail through merging multiple photographs taken at successive focal steps to create a composite image with an extended depth of field. This paper describes the wet imaging components and focus stack photography workflow developed while conducting a large-scale digitization project for targeted reptile and amphibian specimens housed in the University of Colorado Museum of Natural History Herpetology Collection. This methodology can be implemented in other collections settings and adapted for use with fluid-preserved specimen types across the Tree of Life to generate high-quality, taxonomically informative images for use in documenting biodiversity, remote examination of fine traits, inclusion in publications, and educational applications.

Perceived prescription for multifocal contact lenses

AbstractPurpose: Multifocal contact lenses have a variable power map that is typically radial. The prescription of these lenses is given as a Sphere plus Addition values in diopters. They are calculated by assigning different radial rings of the lens to different mean power values (near and far vision zones). Depth of focus (DOF) should be high in order to focus both images on the retina. This calculation usually depends on each manufacturer and design type. The purpose of this work is to give a simple common criterion for perceived prescription, based on visual criteria and patient's pupil.Methods: The radial power profile of different multifocal contact lens designs was measured with a NIMO TR1504 (Lambda‐X). Using geometrical optics and MATLAB, ray tracing is performed and the position of the smallest spot size plane, noted as Df, is recorded. Spot size in that plane is recorded too. From Df, graphs of perceived diopters (inverse of Df in meters) versus different diameter portions of the lens are obtained.Results: The method provides the sphere and addition values for lenses with zonal designs based on the maximum and minimum effective power seen by the patient as a function of pupil size. The main perceived diopter grows or decrease smoothly depending on centre‐near or centre‐distance designs. The calculation of the approximate size of the spot with the diameter also allows estimating the DOF too. In Extended Depth of Focus (EDOF) lenses the method is also applicable without changes of criteria.Conclusions: The determination of the prescription perceived by the patient with multifocal contact lenses is important and there are no uniform methods for the different designs. The inclusion of the diameter used by each patient allows the inclusion of visual criteria for calculation of main perceived diopter and the use of a common method.

Analysis of the effects of visual quality under different light conditions in different intraocular lenses: Study pilot

AbstractPurpose: To compare the effects on visual function and quality of life in cataract patients undergoing cataract surgery between different extended depth of focus (EDOF) lenses, when subjected to different illumination conditions.Methods: Observational, prospective, cross‐sectional pilot study with a total of 31 eyes of 15 patients undergoing uncomplicated phacoemulsification cataract surgery with Tecnis Eyhance, Isopure1.2.3 and Vivity intraocular lenses. All patients underwent a complete preoperative examination. They were also evaluated on different days under mesopic and photopic conditions.Results: Thirty‐one eyes of 15 patients (70.5 ± 8.6) were included in the study. Statistically significant values were obtained when comparing intermediate visual acuity (VA) between mesopic and photopic illumination conditions for the Isopure and Eyhance lenses with a value of 0.021 and the Isopure lens with Vivity with 0.001. In photopic conditions at intermediate distance a significant value was obtained between Vivity and Eyhance with a value of 0.02 and in mesopic conditions at intermediate distance between Vivity and Isopure with a value of 0.001. Between the different lenses, no significant values were obtained between the photopic and mesopic conditions. No significant values were found for pupillometry and halometry in mesopic conditions either.Conclusions: All three intraocular lenses provided excellent distance vision in both photopic and mesopic conditions with no statistically significant differences. But in intermediate distance, significant differences were found between photopic and mesopic conditions between the Isopure lens and the Vivity and Eyhance lenses. Therefore, the Isopure lens has worse intermediate VA values in mesopic than the other lenses. There were also no significant differences in near vision in pupillometry and halometry.

Numerical evaluation of intraocular lens decentration

AbstractPurpose: Numerical evaluation of the performance under decentering of an extended depth of focus (EDOF) bisegmented design intraocular lens (IOL).Methods: The optical assessment of The FEMTIS Comfort EDOF‐IOL was evaluated with a ray tracing software using the Atchison model eye (Atchison 2006). Under monochromatic illumination (555 nm) and 4.50 mm pupil, the Modulation Transfer Functions (MTFs) were calculated at the vergences range + 0.50 D to −2.50 D in both tangential and sagittal directions. They were calculated for IOL displacements of 0.25, 0.50 and 1.00 mm in the horizontal and vertical direction. The area under the MTFs (AMTFs) was calculated as the tangential and sagittal MTFs average for frequencies between 0 and 50 cycles/mm.Results: AMTF of the IOL has an EDOF profile. When it is decentered horizontally, the AMTF does not differ significantly from the AMTF of the centered IOL. But if it is decentered vertically the AMTF varies. This is due to the bisegmented design of the IOL.Conclusions: After surgery, decentration may occur due to posterior capsule opacification, capsule fibrosis, etc. (Ashena et al. 2020). Due to its design, this IOL is robust against horizontal decentration, but not for vertical decentration. D.M.‐M. acknowledges the Margarita Salas grant from the Ministerio de Universidades, Spain, funded by the European Union‐Next Generation EU.

Tolerance to lens tilt and decentration of two multifocal intraocular lenses: using the quick contrast sensitivity function method

BackgroundQuick contrast sensitivity function (qCSF) method is an advanced quick method for contrast sensitivity function (CSF) evaluation. This study evaluated the contrast sensitivity (CS) of eyes undergoing cataract surgery with multifocal intraocular lens (IOL) implantation and its tolerance to IOL tilt and IOL decentration using the qCSF method.MethodsPatients undergoing uneventful phacoemulsification and a trifocal IOL (Zeiss AT LISA tri 839MP, Carl Zeiss, Germany) or an extended depth-of-focus (EDOF) IOL (Tecnis Symfony ZXR00, Johnson & Johnsons, USA) implantation were included. Monocular contrast sensitivity was measured using the qCSF method at one month post-surgery. IOL tilt and decentration were measured using an optical aberrometer (OPD-Scan III, NIDEK, Japan).ResultsSeventy-two patients/eyes with the 839MP IOL and 64 patients/eyes with the ZXR00 IOL were included. Area under the log CSF (AULCSF) and CS acuity did not differ significantly between the two groups. The ZXR00 IOL group showed better CS at 1 cpd (1.137 ± 0.164 vs. 1.030 ± 0.183 logCS) and 1.5 cpd (1.163 ± 0.163 vs. 1.071 ± 0.161 logCS), while the 839MP IOL group had better CS at 6 cpd (0.855 ± 0.187 vs. 0.735 ± 0.363 logCS). In the 839MP IOL group, all CSF metrics were negatively correlated with IOL tilt (all P < 0.05), while in the ZXR00 IOL group, the CS at 3 cpd had no significant correlation with IOL tilt (P > 0.05). Among myopic eyes, fewer CSF metrics were negatively correlated with IOL tilt in the ZXR00 IOL group than in the 839MP IOL group. No significant correlation was found between CSF metrics and IOL decentration.ConclusionsThe ZXR00 and the 839MP IOL groups presented comparable CSF. CS was negatively correlated with IOL tilt, instead of decentration in multifocal IOLs, particularly among myopic eyes. The ZXR00 IOL had better tolerance to IOL tilt in myopic eyes.