High Order Aberrations Induced By An Extended Depth Of Focus Intraocular Lens

To objectively evaluate the visual aberrations of an Extended Depth Of Focus (EDOF) Intraocular Lens (IOL) using ray-tracing technology.

AKTINA OPHTHALMOLOGY CENTER 

Two hundred (200) consecutive eyes of 132 patients with cataract that underwent uncomplicated phacoemulsification were included in this prospective study; 150 eyes received the same EDOF IOL (Lucidis 108M, SAV-IOL, Switzerland) and the rest 50 eyes received the same Monofocal IOL (Acrysof IQ, Alcon, USA). Ray tracing aberrometry (iTrace, Texas, USA) was used postoperatively to measure Internal High Order Aberrations that correspond to the implanted IOL (Spherical Aberrations, Internal Coma and Internal Trefoil). The Internal Modulation Transfer Function (iMTF) curve at a pupil diameter of 3mm was plotted and evaluated. Non-parametric Mann-Whitney U test (GraphPad Prism, v8.0, San Diego, CA, USA) was used.

Internal Coma and internal Trefoil aberrations did not differ between the EDOF and the Monofocal IOL groups (p=0.087 and p=0.752 respectively). EDOF IOLs induced negative Spherical aberrations that were significantly different from the close to zero Spherical aberrations induced by the aspheric Monofocal IOLs (average -0.064μm and -0.002μm RMS respectively; p<0.001). This explains the mechanism of near vision in this specific EDOF IOL. The iMTF curve in the EDOF group, although significantly lower than the Monofocal group (p<0.001 at all measured spatial frequencies), was found to be higher than the minimum MTF required for sufficient contrast sensitivity in routine activities.

The specific EDOF IOL that was tested induces negative Spherical aberrations that are important for its near-vision function without compromising contrast sensitivity required for routine activities. The rest of the aberrations do not differ from a Monofocal IOL.