Official ESCRS | European Society of Cataract & Refractive Surgeons


Clinical evaluation of light-spectrum effects on the visual performance in patients with a diffractive extended-depth-of-focus intraocular lens

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Session Details

Session Title: Extended-Depth-Of-Focus IOLs I

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 14:18

Venue: Free Paper Forum: Podium 1

First Author: : G.Labuz GERMANY

Co Author(s): :    R. Khoramnia   A. Özen   H. Son   T. Yildirim   G. Auffarth                 

Abstract Details


Diffractive technology used in multifocal intraocular lenses (IOLs) is optimized for one wavelength. Optical performance changes, however, if that specific wavelength is not used. Laboratory studies have demonstrated that the image quality of refractive-diffractive IOLs in longer wavelengths is improved at far but worsens at intermediate and near. We aimed to study this effect in vivo. Under different spectral conditions, we examined the visual quality and chromatic-aberration effects of patients who had a refractive-diffractive extended-depth-of-focus IOL.


International Correction Research Center, Department of Ophthalmology, University of Heidelberg, Germany.


Twelve patients (23 eyes) with a Symfony (J&J Vision) participated in this study. The visual quality was determined at far, intermediate (80cm) and near (40cm). Postoperative logMAR corrected distance visual acuity (CDVA) as well as distance corrected intermediate (DCIVA) and near (DCNVA) visual acuity were assessed. Contrast sensitivity was tested at a range of distances and spatial frequencies. The visual function was studied monocularly with (1) a red filter and compared with white-light results obtained with (2) a neutral-density filter to correct for lower transmission of the red filter. Spectacle correction in red light was adjusted for chromatic-aberration effects.


The adjustment of refractive error following the insertion of the red filter was -0.05D ±0.20D. CDVA in red light (-0.03±0.1) was minimally better than in white light (-0.01±0.1). However, DCIVA and DCNVA were higher with white than red light. At 80cm and 40cm, visual acuity was 0.11±0.11 (white) and 0.17±0.1 (red), and 0.31±0.11 (white) and 0.40±0.12 (red), respectively. Contrast sensitivity was slightly better with a red filter at far, but it was worse at intermediate. Near contrast sensitivity was significantly higher in white than red light.


We demonstrated that the spectral dependency of the Symfony’s diffractive technology might affect patients’ vision. Although distance visual quality only minimally improved in red light, at near, we found a significant deterioration of the visual performance compared to white light. The Symfony's chromatic-aberration correction proved effective in vivo.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a competing company

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