Comparison of Five Presbyopia-Correcting Intraocular Lenses: Optical-Bench Assessment with Visual-Quality Simulation

Grzegorz Łabuz; Weijia Yan; Isabella D Baur; Ramin Khoramnia; Gerd U Auffarth

doi:10.3390/jcm12072523

Comparison of Five Presbyopia-Correcting Intraocular Lenses: Optical-Bench Assessment with Visual-Quality Simulation

J Clin Med. 2023 Mar 27;12(7):2523. doi: 10.3390/jcm12072523.

Authors

Grzegorz Łabuz¹, Weijia Yan¹, Isabella D Baur¹, Ramin Khoramnia¹, Gerd U Auffarth¹

Affiliation

¹ Department of Ophthalmology, David J. Apple International Laboratory for Ocular Pathology, Heidelberg University, 69120 Heidelberg, Germany.

Abstract

Presbyopia correction through implantation of a trifocal intraocular lens (IOL) is a modality offered to both cataract and refractive-lens exchange patients. To maximize postoperative satisfaction, IOL selection needs to be made based on patients' requirements aligned with the available technology. Five Trifocal IOLs were assessed in this study, and their differentiating features were identified: Triumf POD L GF, AT Lisa Tri, Tecnis Synergy, AcrySof IQ PanOptix, and Acriva Trinova Pro C. The optical quality was assessed using the modulation-transfer-function principle. Simulated defocus curves were derived from a non-linear formula. Far-focus simulated visual acuity (simVA) was 0.03 logMAR or better for all the studied IOLs, showing minimal differences. However, each IOL's intermediate focus position differed across a range from 61 cm to 80 cm; and for the near focus, it was 36 cm to 44 cm. Triumf demonstrated improved intermediate point at the expense of the near focus resulting in a lower predicted near VA. PanOptix exhibited the shortest range of vision without a clear distinction between intermediate and near-point. The remaining lenses presented three foci of comparable optical quality and, thus, simVA performance. Each model, however, revealed a different aperture-change response. Trinova function improved at intermediate but was worse at near for larger pupils. The opposite was observed for AT Lisa. Synergy's optical quality change was predominantly associated with lower pupil diameter. In conclusion, the trifocal IOLs can be differentiated according to their secondary-foci position, light-energy distribution, and pupil-size-related behavior. The observed differences may translate directly into a clinical effect showing that the trifocal IOLs vary in their ability to deliver optimal vision at different distances, with some providing improved intermediate while others favor reading distance. The knowledge gained through this objective testing can support IOL selection, postoperative patient counselling and increase the chance of spectacle independence after surgery.

Keywords: modulation-transfer-function; optical quality; trifocal intraocular lens.

Grants and funding

Supported by a research grant from VSY Biotechnology. The David J Apple Laboratory receives support from the Klaus Tschira Foundation, Heidelberg, Germany. Isabella D. Baur is funded by the Rahel Goitein-Straus-Program of Heidelberg University Faculty of Medicine. The funding organizations had no role in the design or conduct of this research or in the preparation of the manuscript.