Abstract

Purpose : To measure through-focus visual acuity curves in pseudophakic subjects with different values of spherical aberration induced by an adaptive optics visual simulator. The situation aimed to evaluate the performance of Extended Depth of Focus (EDOF) Intraocular lenses.

Methods : Through-focus visual acuity was measured in 20 pseudophakic subjects (age 63 ± 10 years old) with an adaptive optics visual simulator optimized for clinical uses (VAO, Voptica SL, Murcia, Spain). This instruments permits performing visual testing under controlled optical conditions. Measurements were made under five different net values of induced spherical aberration: 0, -0.07, -0.15, -0.23 and -0.30 mm (pupil dimeter of 4.5 mm). For comparison, ray tracing simulations were also performed.

Results : On average, depth of focus was extended when spherical aberration increased from -0.07 to -0.15 mm (4.5 mm pupil diameter). However, there were significant individual variations where depth of focus could be improved with a higher value of spherical aberration (35% of subjects) without compromising distance visual acuity. Also, there were subjects (30%) who exhibited no visual benefit of increasing (negative) spherical aberration as visual acuity dropped well below acceptable levels. Depth of focus calculations based on raytracing showed general agreement with the measurements, although the relationship between visual acuity and Strehl Ratio was non-linear.

Conclusions : The visual conditions of an EDOF intraocular lens can be recreated in a population at the typical age for IOL implantation. The variability of the through-focus curves suggests that visual performance simulations prior cataract surgery can be used to select the EDOF IOL providing the best possible visual outcome. Adaptive optics visual simulators are a useful tool for customization.

This abstract was presented (poster) at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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