Official ESCRS | European Society of Cataract & Refractive Surgeons


Adaptive optics visual simulation of trifocal IOLs to predict postoperative success

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Session Details

Session Title: Multifocal IOLs I

Session Date/Time: Sunday 15/09/2019 | 16:30-18:00

Paper Time: 16:36

Venue: Free Paper Forum: Podium 1

First Author: : E.Villegas SPAIN

Co Author(s): :    L. Hervella   S. Manzanera   P. Prieto   P. Artal                    

Abstract Details


To evaluate defocus curves of a trifocal diffractive intraocular lens (IOL) profile using an Adaptive Optics Visual Simulator VAO (Voptica SL, Murcia, Spain).


Laboratory of Clinical Optics, University of Murcia, Spain.


VAO combines optical measurements and visual testing. A Hartmann-Shack wave-front sensor measures objective refraction and aberrations, together with a spatial light modulator capable of correcting or inducing any optical profile while performing visual testing. Best corrected visual acuity (BCVA) and through focus visual acuity (VA) from +0.50 to -3.5 D in steps of 0.50D were measured in 20 dilated eyes of different subjects looking through a customized diffractive trifocal profile with intensity distribution of 45%, 20% and 35% at far (0.00 D), intermediate (1.40 D), and near (2.80 D) viewing distances, respectively.


The mean value of LogMAR BCVA was 0.01±0.11. With the trifocal profile, the mean values of VA were 0.11±0.13, 0.23±0.12 and 0.20±0.13 at far, intermediate (1.50 D) and near (3.00 D). In all subjects, the VA at far distance with IOL profile was slightly lower than the BCVA, not more than 0.15 LogMAR, except in three subjects with differences of 0.2 LogMAR. There was a significant reduction of VA, higher than 0.15 LogMAR, from far to intermediate distances in four subjects, and from far to near distances in two subjects.


The evaluation of defocus curves of a trifocal diffractive IOL profile using the VAO adaptive optics visual simulator showed a high variability between different subjects. VAO offers the possibility of detecting a significant visual loss as a result of diffraction effects at any viewing distance before surgery. This procedure could improve the selection of patients reducing the number of postoperative dissatisfied patients and optimizing the outcomes.

Financial Disclosure:

has significant investment interest in a company producing, developing or supplying product or procedure presented, is employed by a for profit company with an interest in the subject of the presentation

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