Impact Of Diffractive Intraocular Lenses On The Natural Balance Of Ocular Chromatic-Monochromatic Aberrations

Although optical aberrations typically degrade the retinal image quality, the existence of positive interactions between chromatic and monochromatic aberrations have proved to benefit visual acuity (VA). This study investigates whether diffractive presbyopia-correcting multifocal intraocular lenses (IOLs) disrupt the beneficial interaction between chromatic and monochromatic aberrations in the eye. Specifically, it evaluates the visual performance of lenses using the zero-diffraction order for far vision and the first diffraction order for near vision (i.e., 0F/+1N design) under different light conditions.

Applied Optics and Image Processing Research Group. Universitat Politècnica de Catalunya – BarcelonaTech, Spain

Hospital de Mataró, Consorci Sanitari del Maresme, Spain.

Presbit clinic. Sabadell, Spain

Creu Groga clinic. Calella, Spain

Eurolaser clinic. Mataró, Spain

Monocular VA of pseudophakic subjects was assessed under white (W) (White LED, CCT=6500K) and green (G) (Green LED, 530 ± 16 nm) light conditions with constant luminance (25.3 ± 0.10 cd/m²) using standard methods, procedures, and materials employed in routine clinical examinations. Diffractive trifocal IOLs (Finevision Micro F12, PhysIOL, n= 20; AT LISA tri 839MP, Zeiss, n= 20) were compared with monofocal IOLs (Y601075, AJL Ophthalmic, n=30).

Far visual acuity (VA) was superior to near VA in all groups under both W and G light conditions. Despite being close to the lens design wavelength and the maximum efficiency of human vision in photopic conditions, G light consistently resulted in lower mean VA compared to W light across all groups and for both far and near distances. This trend likely stems from defocus caused by residual refractive errors.

The decrease in VA with G light was minimal for the monofocal pseudophakic subjects. For subjects implanted with diffractive trifocal IOLs, the decrease in VA with G light was subtle in far vision but became relatively more pronounced in near vision.

Within the limitations of clinical VA examination, our results prove that diffractive multifocal IOLs with 0F/+1N design preserve the beneficial interaction between chromatic and monochromatic aberrations at both far and near vision. These findings are specific to the 0F/+1N design and cannot be extrapolated to other diffractive lens types.