Rounded IOL edges distribute reflected glare image over a significantly greater area than sharp edges. Rounded edges reduce the potential for edge glare phenomena that appear to the patient as a thin crescent or partial ring.
The optical performance of one monofocal and five multifocal lenses was evaluated in the laboratory and photographically. The laboratory testing included determination of the modulation transfer function (MTF), through focus response (TFR), resolution efficiency, and Strehl ratio of each lens. The photographic testing included photographs of the Regan high contrast acuity chart at ten feet with clearest focus and 18 additional photographs in which the image was defocused using minus trial lenses in 0.25 diopter increments. A color photograph of the Kodak color chart was also taken using each lens. All testing was conducted using a 3 mm artificial pupil under ideal implant conditions with no decentration or tilt. The laboratory and photographic results demonstrate that all the multifocal lenses had a two- to three-fold increase in the depth of field with at least a 50% lower contrast in the retinal image. The photographic testing revealed a one to two line better resolution limit with the monofocal lens, which corresponded to the 12% to 41% better MTF cut-off value with the monofocal lens by laboratory testing. The measured resolution efficiencies of all six lenses were comparable. The color photographs revealed color mixing of adjacent colors with the multifocal lenses, whereas the colors appeared unchanged from the original with the monofocal lens.
Both study groups reported similar visual phenomena. The difference between those who were bothered by the visual sensations and those who were not appears to be a function of individual tolerance. The visual sensations may be mitigated with minus-lens overcorrection.
We describe a methodology to predict the outcome of clinical tests caused by changes made to the optical elements of the human eye. This formalism, called the expected visual outcome model, is based on in vitro measurements of the optical transfer function and takes into account a simple model of human threshold performance. The clinical tests under consideration are high-contrast visual acuity and contrast sensitivity. Using the expected visual outcome, we describe a useful performance index called the predicted visual acuity graph, which can be measured clinically. The theoretical results are compared with visual function measured in patients with pseudophakic (multifocal and monofocal) implants.
The optical performance of new multifocal intraocular lens designs is frequently assessed using the modulation transfer function (MTF). We discuss the relationship between the MTF and clinical measures of human visual function, such as threshold visual acuity and contrast sensitivity. Using in vitro MTF measurements of a human eye model containing a multifocal or monofocal intraocular lens, we predict relative changes in acuity and contrast sensitivity and outline the techniques using a simple model of human retinal threshold detection. Specific concepts introduced include the visual acuity graph, predicted visual acuity graph, and predicted contrast sensitivity function.
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