Intraindividual Comparison Of Two Presbyopia-Correcting Iol Concepts And Their Combination Using The Real Artificial Lens Vision (Ralv®) System
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT519 | Type: Free paper | DOI: 10.82333/j7m7-dh85
Authors: Prof. Dr Claudette Abela-Formanek* 1 , Dr Marcus Lisy 1 , Dr Victor Danzinger 1 , Dr Nikolaus Mahnert 1 , Prof. Dr Daniel Schartmüller 1 , Prof. Dr Markus Schranz 1
1Ophthalmology and Optometry,Medical University of Vienna,Vienna,Austria
Purpose
Extended depth of focus intraocular lenses can be categorized into Full Depth of Field (FDoF) and Partial Depth of Field (PDoF) designs. While FDoF IOLs aim to provide greater spectacle independence, they are often associated with reduced contrast sensitivity and increased photic phenomena (halo, glare). PDoF IOLs offer superior optical quality but more limited near performance. A mix-and-match strategy may combine the advantages of both concepts. This study aimed to intraindividually compare visual performance of FDoF, PDoF, and a combined approach using the Real Artificial Lens Vision (RALV®) system.
Setting
Prospective study at a tertiary referral center
Methods
Six weeks after cataract surgery and bilateral implantation of monofocal IOLs, patients were evaluated using the RALV® system, an instrument that allows subjects to look through real intraocular lenses in a noninvasive, intraindividual setting.
Under distance refractive correction, participants viewed through real IOLs. Three lens combinations (PDoF–PDoF, FDoF–FDoF, and PDoF–FDoF [mix-and-match]) were tested in randomized order. Distance visual acuity (Snellen), contrast sensitivity (logCS, Weber), quantitative halo assessment, and defocus curves were analyzed.
Results
Measurements from 36 patients were analyzed. Distance visual acuity was significantly reduced with FDoFIOLs (0.80 ± 0.15) compared with PDoF IOLs (0.94 ± 0.13; p = 0.012), whereas the mix-and-match combination demonstrated comparable values (1.01 ± 0.18; p = 0.084 vs PDoF).
Contrast sensitivity was lower with FDoF (1.19 ± 0.17 logCS) compared with PDoF (1.37 ± 0.16; p = 0.009) and mix-and-match (1.37 ± 0.18; p = 0.038).
Objective halo perception was significantly increased with FDoF IOLs (16.0 ± 3.6) compared with PDoF (13.4 ± 3.1; p = 0.007) and the mix-and-match approach (12.6 ± 3.2; p = 0.026).
Regarding defocus curves, FDoF IOLs demonstrated the largest area under the curve, followed by the mix-and-match combination and PDoF.
Conclusions
Compared with PDoF, bilateral FDoF implantation was associated with reduced distance visual acuity, decreased contrast sensitivity, and increased halo perception, while providing the broadest functional range of vision.
The mix-and-match strategy maintained optical quality comparable to PDoF while extending the depth of focus. These findings suggest that combining FDoF and PDoF IOLs may offer a balanced visual profile and represent a promising alternative for individualized presbyopia correction.