Correlation Of Subjective Clinical Visual Disturbance Scores With Simulated Vehicle Headlight Halo In Presbyopia Correcting Iols

To evaluate correlation between bench halo and clinical experience from standardized questionnaires (QUVID: Questionnaire for visual disturbances) for various monofocal and presbyopia correcting IOL (PC-IOL) optical designs (diffractive, refractive, and wavefront shaping). 

Clinical experience was taken from validated QUVID data in subjects bilaterally implanted with one of the study IOLs (TFNT00, ZXR00, 829MP, DFT015, SN60AT, SN60WF). Data on proportion of QUVID scores were taken 6-Months post-op in subjects better than 0.2logMAR.  Bench halos were measured using the high dynamic range system with a pinhole simulating a 100 mm headlight at 31 m. IOLs were mounted in a model eye with matched corneal spherical aberration, and an external pupil scaled to 4.5 mm at the IOL plane. Using 4x images, area under the curve (AUC) of light intensity (set just below saturation with a monofocal IOL, or about 20,000 cd/m2) plotted by visual angle up to 3 deg was calculated.

Validated questionnaire data showed greater proportion of subjects reporting moderate/severe halos with diffractive IOLs compared to wavefront shaping and monofocal IOLs (Diffractive: 29 to 36%; Non-diffractive: 11%; Monofocals: 4-7%). Bench halo AUC showed diffractive IOLs produced larger halos than the non-diffractive IOLs, with the wavefront shaping EDF IOL having an AUC closest to the monofocal control (Diffractive: 1448 to 1677; Non-diffractive: 997; Monofocals: 1002 to 1008) Results show moderate to high correlation between bench halo AUC and patient-reported halo severity (No halo: r=0.85; Mild/Little halo: r=0.66; Moderate/severe halo: r=0.9).