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The effect of multifocal IOLS on eyes with previous refractive surgery: in vitro simulations with Mini WELL, TECNIS Symfony and Lentis Mplus

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Session Details

Session Title: Pseudophakic IOLs: Enlarged Depth of Focus

Session Date/Time: Tuesday 10/10/2017 | 08:30-10:30

Paper Time: 10:02

Venue: Room 3.1

First Author: : V.Camps SPAIN

Co Author(s): :    D. Pinero   J. Miret   A. Tolosa   A. Sabater           

Abstract Details


The aim of this paper is to propose a method to evaluate the theoretical optical performance of a multifocal IOL implanted in eyes that have previously undergone myopic or hyperopic refractive surgery. This method combine in vitro IOL wavefront aberration measurement, real topographies and ray-tracing simulation.


University of Alicante (Spain)


A method based on the calculation of through focus MTF curves to evaluate the effect of multifocal IOLs over patients that have undergone previously refractive surgery was developed. For the simulations, the spherical aberration of the IOLs and the topography data of two eyes that had undergone myopic and hyperopic laser refractive surgery were required. All measures were performed for exit pupil sizes of 3, 4 and 4.7 mm. Three multifocal IOLs were analyzed, The Mini Well (MW), The TECNIS Symfony ZXR00 (SYM) and the Lentis Mplus X LS-313 MF30 (MP)


For the eye with previous myopic refractive surgery, the MW maintained three focus but the SYM and the MP lost the near and intermediate focus as the pupil increased. The positive spherical aberration was always compensated by the three IOLs. While the eye with previous hyperopic refractive surgery the MW showed peaks for near, intermediate and far distance for all pupil sizes. The SYM only provided a near focus as the pupil size increased and the MP showed a near focus for 3 and 4 mm. All the IOLs increased the negative spherical aberration achieving unacceptable values for 4.7 mm.


Our simulations indicated that the optical quality of the system eye+IOL was worsened when the eye had undergone previously a refractive surgery. This worsening is more evident as the pupil size increases and the eye has undergone hyperopic refractive surgery. Considering the spherical aberration, the three IOLs compensated the positive spherical aberration of the eye that had undergone myopic refractive surgery and increased the negative spherical aberration of the eye that had undergone hyperopic refractive surgery.

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