Purpose : Adaptive optics (AO) vision simulation is able to predict the clinical visual outcomes of pseudophakic patients implanted with either refractive or diffractive intraocular lens (IOL) designs reasonably well (Schwarz et al. ARVO 2014; Manzanera et al. ARVO 2015). The purpose of this study was to evaluate the through-focus contrast sensitivity (CS) provided by monofocal and multifocal IOLs using the AO visual simulator.
Methods : The phase profile of an aspheric, a spherical monofocal and three diffractive multifocal IOLs with different add powers (+2.75, +3.25 and +4D) were induced bilaterally by an AO visual simulator in 4 cyclopleged subjects for a 4.5 mm pupil in white light under mesopic conditions. CS was measured at 6 and 12cpd using the QUEST method at three different defocus positions (0, -0.75 and -1.5D of defocus). The results at 0D were compared with the clinical data of pseudophakic patients implanted with the same IOL designs measured using a Vector Vision or an Optec 6500 chart.
Results : The CS at 6 and 12cpd for the five IOL designs provided a good correlation with the clinical CS at distance. CS decreased linearly with defocus for monofocal and multifocal IOLs (R^2> 0.81 and 0.82 for 6 and 12cpd respectively) except for the lowest-add multifocal IOL (R^2= 0.23 and 0.20 for 6 and 12cpd respectively). For multifocal IOLs, the higher the add power, the faster the reduction of the CS with defocus. For example, at 6cpd, the ratio was -0.08, -0.22 and -0.30logCS/D for 2.75, 3.25 and 4D of add power respectively. Monofocal IOLs had higher ratio of change and provided significantly better CS at 0 and -0.75D than multifocal IOLs at 6 and 12cpd. At intermediate vision, the reduction of the add power improved CS.
Conclusions : CS measured with the AO visual simulator resembled the clinical performance of patients implanted with the same IOL designs at far. The evaluation of the through-focus CS showed that the CS decreased linearly with the defocus in a defocus range between 0 and -1.5D for monofocal and multifocal IOLs with high add power. Monofocal IOLs provided the better CS at 0 and -0.75D while multifocal IOLs with the lower add power provided better CS at -1.5D.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.