The visual performance at near distance with the IOL evaluated improved in eyes with less corneal power. On the other hand, a slight temporal IOL decentration from vertex normal also improved intermediate visual acuity. The binocular defocus curve was similar to other trifocal IOLs.

The biomechanically corrected IOP measured after surgery with the dynamic Scheimpflug analyzer showed better agreement with the preoperative values than IOP. The stiffness parameter was not dependent on the amount of removed corneal thickness. A new sign correlated with dynamic corneal densitometry was found and might be related to changes in corneal hydration and biomechanics.

Intracameral combination of 2 mydriatics and 1 anesthetic is an alternative to topical mydriatics for cataract surgery. The prompt onset of pupil dilation and the stable mydriasis induced by this drug combination improved the intraoperative conditions during crucial steps, such as intraocular lens implantation.

Objective:To evaluate the repeatability of the fast measurement of the visual acuity (VADC) and contrast sensitivity (CSDC) defocus curves with a new test as well as the agreement of measurements at far distance obtained with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the ClinicCSF test for measuring Contrast Sensitivity Function (CSF).Method:Records from fifty-nine subjects implanted with Multifocal Intraocular Lenses (MIOLs) were retrieved from our database. VADC and CSDC were measured from +1.00 D to -4.00 D in 0.50 D steps. The agreement with the ETDRS and the CSF at far distance was assessed in comparison to the 0 D location of the VADC and the CSDC, respectively. The repeatability was evaluated in 34 subjects who consecutively repeated two measures.Results:Median Visual Acuity (VA) was -0.1 logMAR with the VADC at 0 D of defocus and 0 logMAR with the ETDRS (p>0.05). A total of 45.8% of eyes showed no differences between both tests and the difference was less than one line of VA in 96.6% of the eyes. The intrasubject repeatability was under one line of VA along all the defocus curve except for positive defocus levels. The CSDC showed the best agreement with the CSF for 18 cycles per degree. The CSDC was less repeatable than VADC. Mean time spent on completing the VADC and CSDC was 7.81 and 7.98 minutes, respectively.Conclusion:The VADC showed good agreement with the ETDRS and good repeatability despite the short testing time. In contrast, poorer repeatability was found for CSDC. Our method would facilitate the inclusion of VADC in clinical practice as it is a fast test, being also the first one including the measure of CSDC.

PURPOSE: To evaluate whether the prediction of visual performance based on the modulation transfer function area (MTFa) calculated with optical simulations is better correlated with visual acuity or contrast sensitivity obtained from defocus curves in patients implanted with a trifocal intraocular lens. METHODS: Biometric eye data from 43 patients were used to create a mean eye model. A trifocal intraocular lens with a power obtained from the mean of the eyes implanted was incorporated into the model and the MTFa was calculated at the 11 defocus planes corresponding the 11 defocus locations measured in clinical practice. Simulations were conducted for pupil diameters of 2.5, 3, 3.5, and 4 mm. The MTFa correlation with visual acuity and contrast sensitivity was evaluated with the mean obtained after stratification of the clinical sample in four groups according to the previous pupil diameters. RESULTS: A linear model predicted the visual acuity and contrast sensitivity from MTFa with similar accuracy to nonlinear models, with R 2 approximately 0.50 for visual acuity and approximately 0.42 for contrast sensitivity. A change of −0.01 logMAR and −0.02 logC was produced per unit of MTFa for visual acuity and contrast sensitivity, respectively. The mean difference between the visual acuity and contrast sensitivity obtained from the model and that measured in clinical practice was close to zero, but the bias varied depending on the defocus lens used, with higher deviation at −0.50 and −3.00 diopters of defocus. CONCLUSIONS: The MTFa obtained from optical simulations can be used to predict the mean visual acuity and contrast sensitivity consistently, with contrast sensitivity being more sensitive but with higher bias. [ J Refract Surg. 2019;35(12):789–795.]