Pre-Clinical Evaluation Of Glare Phenomena In Presbyopia-Correcting Intraocular Lenses

To assess and compare pre-clinical glare phenomena, quantified by the straylight parameter, in the latest generation of presbyopia-correcting intraocular lenses (IOLs) from different manufacturers using a clinical straylight measurement system adapted for in vitro evaluation.

David J. Apple Center for Vision Research, Department of Ophthalmology, University Eye Clinic Heidelberg, Heidelberg, Germany.

18 IOLs were analyzed (6 groups; n=3 per group), each with nominal power +20.0 D. Lenses included enVista Monofocal, enVista Envy, and LuxLife (Bausch + Lomb); TECNIS Odyssey (Johnson & Johnson Vision); Clareon PanOptix Trifocal (Alcon); and FINEVISION HP (POD F GF) (BVI Medical). Glare potential was quantified in vitro by forward light scattering using a C-Quant straylight meter (Oculus GmbH, Germany) adapted for bench testing. Straylight was measured at visual angles of 2.5°, 3.5°, and 7°. The logarithm of the straylight parameter (logs) was analyzed and reported in clinical log units; higher logs indicate stronger glare perception and larger halos. Published straylight of isolated crystalline lenses was used as a physiological reference.

At 7°, all IOLs demonstrated low straylight values (<0.3 logs), comparable to or below those of a young crystalline lens. At smaller visual angles (2.5° and 3.5°), angular dependency differed according to optical design. The monofocal enVista and the refractive trifocal IOL (LuxLife) showed consistently low straylight across all angles (≤0.3 logs). Among diffractive trifocal IOLs, enVista Envy and FINEVISION HP (POD F GF) maintained low and stable values. In contrast, TECNIS Odyssey exhibited elevated straylight at 2.5° and 3.5° (nearly 1.1 logs), approaching values reported for an aged crystalline lens, followed by a reduction at 7°. Clareon PanOptix demonstrated a moderate elevation at smaller angles.

Assessment at multiple visual angles reveals design-related differences in straylight, and thus glare perception, that are not detectable at 7° alone. Small-angle straylight differs among trifocal designs; the TECNIS Odyssey shows higher straylight at smaller angles, closer to a glaring source. By contrast, enVista Envy and FINEVISION maintained low straylight levels, close to those of the refractive IOLs.