SIMULATED VISUAL RANGE OF A SMALL-APERTURE LENS: A COMPARISON WITH MONOFOCAL, EXTENDED-DEPTH-OF-FOCUS AND TRIFOCAL TECHNOLOGY
Published 2024 - 28th ESCRS Winter Meeting
Reference: P064 | Type: Submission | DOI: 10.82333/hecc-5209
Authors: Grzegorz Labuz* 1 , Weijia Yan 1 , Ramin Khoramnia 1 , Gerd Auffarth 1
1Department of Ophthalmology,Heidelberg University Eye Clinic,Heidelberg,Germany
Purpose
The IC-8 (AcuFocus) is an intraocular lens (IOL) that uses a small-aperture diffractive principle to expand the visual range of pseudophakic patients. This study aimed to evaluate the image quality of the IC-8 and compare it with a standard monofocal, as well as extended-depth-of-focus (EDoF) and trifocal IOLs featuring diffractive zones.
Setting
David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Germany.
Methods
An optical-bench setup was used to study image-quality metrics of the pinhole IOL, conducting a comparative analysis with Tecnis monofocal and echelle-based Symfony IOLs from J&J, as well as a trifocal PanOptix lens (Alcon). The IOLs' modulation transfer function was measured in an aberrated eye model with polychromatic light and a 3-mm artificial pupil. A refractive target of 0D and -0.50D was simulated for the IC-8, while the other IOLs were set to plano. The MTF area was calculated, and the IOLs' performance under induced defocus was compared using simulated VA.
Results
The MTF analysis of the IC-8 showed one extended focus area exceeding the range of the monofocal control by 1D at 0.2 logMAR. The Symfony produced better image quality at intermediate than a plano-target IC-8, but the small-aperture approach yielded comparable simulated defocus tolerance to the echelle-based model after a -0.50D offset. Although the diffractive-trifocal achieved a lower MTF area from distance to the intermediate range, it produced higher optical quality above 1.75D of defocus. Additionally, a simulated-VA improvement of nearly 0.2 logMAR was observed at reading distance with the PanOptix compared to the IC-8.
Conclusion
We demonstrated that the small-aperture lens offers an extended visual range close to that of the Symfony lens, exceeding standard monofocal technology. Introducing a myopic refractive target can further enhance the depth of focus for patients using the small-aperture lens, although it may not be sufficient to achieve the reading experience provided by trifocal IOLs.