Most of the new premium models of intraocular lenses for presbyopia correction use diffractive optics in their optical design. The presence of multiple foci and the difference of the diffractive efficiency for different wavelengths have a great impact in the lens optical performance. In this context, there is a limited information available for clinicians to understand the optical principles that differentiate each design and their potential influence on clinical outcomes. Optical bench studies with polychromatic light are necessary to solve this limitation. In this work, a custom made optical bench was employed to assess with polychromatic light the through the focus optical quality of three different IOL designs: trifocal, EDOF effect; and enhanced monofocal. By using different and complimentary approaches: images of the USAF test, axial PSFs and TF-MTFs, each design revealed its intrinsic features, which were not previously reported for these IOLs models in a comparative way. It was found that the chromatic aberration plays a very important role in the performance of each IOL. Our results could help clinicians to understand the optical principle of each lens and also provide useful information for choosing the lens that best suits the needs of the individual patient.

This study aimed to evaluate in vitro performance refractive segmented EDOF intraocular lenses under polychromatic light using an optical bench that complies with the ISO 11979-2 Norm. The through focus modulation transfer function (TF-MTF) of the Femtis Comfort LS-313 MF15 (Oculentis GmbH, Berlin, Germany) IOL was evaluated for IOLs with three different base powers. The effect of the asymmetry of the segmented designs was evaluated with 3 different wavelengths and with polychromatic light at a 3.0 mm and 5.0 mm pupil diameter. It was demonstrated that the TF-MTF curves exhibit a bifocal profile that, in practice, results in an EDOF design. As a consequence of the LCA, the TF-MTF values in white light were lower than in monochromatic light. Images of the USAF test chart were obtained to confirm the prediction of the TF-MTFs. We found that Femtis Comfort is a bifocal low-addition IOL and this fact can result in an EDOF effect which was obtained previously in clinical trials. Moreover, we showed that the base power influences the IOL optical quality, which results as more effective for high powers (hyperopic eyes) than for low powers (myopic eyes). The LCA of the segmented refractive design was very low and presumably not clinically relevant.

In this work, we analyze a proposal of a new intracorneal diffractive lens for presbyopia correction that could allow good, distance, intermediate and near vision. By using an adaptive optics visual simulator, we study the influence of two factors in the inlay performance: the spherical aberration (SA) and the potential errors of in thickness, induced in the manufacturing process. We show that the inlay through-the-focus imaging performance can be customized with the SA value, favoring either distance–intermediate or intermediate–near vision. Moreover, we found that with thickness variations of 10%, the inlay still maintains its trifocal nature.

This study aimed to evaluate the optical performance of a rotationally asymmetric intraocular lens (IOL) when it is decentered relative to the visual axis. The FEMTIS Comfort IOL (Teleon Surgical B.V., Spankeren, The Netherlands) was assessed using ray tracing software in the Atchison model eye at apertures of 3.0 mm and 4.5 mm. The metric used for assessment was the through-the-focus area under the modulation transfer function (TF-MTFa). Decentrations of 0.2 mm and 0.4 mm were considered. Our results indicated that the MTFa defocus curves exhibited significant differences depending on the direction of vertical decentration. Downward decentrations shifted the MTFa curve towards virtual vergences, resulting in improved optical quality at far distances but decreased optical quality at intermediate and near vision. Conversely, upward decentrations produced the opposite effect. Since, on one hand, this lens is fixed within the capsulorhexis during surgery, demonstrating excellent stability, and on the other hand, the precise centration of the capsulorhexis can be made accurately off the visual axis, these results provide surgeons with the opportunity to plan various clinical scenarios to optimize surgical outcomes with this IOL by selecting the optimal location for capsulorhexis centration in each patient.