Optical bench performance of AcrySof® IQ ReSTOR®, AT LISA® tri, and FineVision® intraocular lenses

Abstract

PurposeTo compare the resolution and optical quality of the ReSTOR® +3.0 D and ReSTOR +2.5 D multifocal intraocular lenses (IOLs) with the AT LISA® tri and FineVision® trifocal IOLs.MethodsResolution, image quality, and photic phenomena were evaluated in the AcrySof® IQ ReSTOR +3.0 D and +2.5 D multifocal IOLs and compared with the AT LISA tri 839MP and FineVision Micro F12 trifocal IOLs, using a Badal optometer and a Snellen visual acuity chart. Simulated headlight images were obtained using a modulation transfer function (MTF) bench and a 50 μm pinhole target. MTF values, using vertical and horizontal slits, were determined at far, intermediate, and near distances.ResultsResolution at 20/40 Snellen visual acuity equivalence was attainable over nearly the entire viewing distance range with the AT LISA tri and FineVision IOLs, but background shadows were more prominent with the AT LISA tri and FineVision IOLs than with the ReSTOR IOLs. Distance MTF peaks at 20/20 Snellen–equivalent spatial frequency were greatest for ReSTOR +2.5 D and ReSTOR +3.0 D IOLs. The near MTF peak occurred at 53 cm with ReSTOR +2.5 D and had a 20/20 Snellen–equivalent value that was lower than the near peaks of the other models but higher than the intermediate foci of the trifocal IOLs.ConclusionAT LISA tri and FineVision trifocal IOLs achieved a useful third focus for intermediate vision but were associated with increased background halos and reduced distance visual quality compared with ReSTOR +2.5 D and +3.0 D multifocal IOLs.

Clinical comparison of patient outcomes following implantation of trifocal or bifocal intraocular lenses: a systematic review and meta-analysis

“…Decreases in contrast sensitivity are reported to be less satisfactory with multifocal IOLs than with monofocal IOLs81213. There is always some concern that the additional focal point provided by a trifocal IOL may reduce contrast sensitivity more than bifocal IOLs by splitting light into three foci9. However, our findings show that contrast sensitivity was unlikely to be more problematic with trifocal IOLs.…”

“…Since all studies indicated that the trifocal group achieved better intermediate VA than the bifocal group1234567, there was reason to believe that the statistically significant difference was clinically meaningful. Previous bench studies comparing the multifocal components of both IOLs found that trifocal IOLs provide a true third intermediate focal point not found with bifocal IOLs910. Considering that no significant differences were present between the two groups in refraction outcomes, IOL optical behavior appears to be the main factor for this finding6.…”

“…Manufacturers have recently introduced multifocal IOLs that are trifocal in design, providing functional far, intermediate, and near vision2678. Optical evaluation of multifocal IOLs has demonstrated that trifocal IOLs achieved a useful third focus for intermediate vision but were associated with increased background glare and halos and reduced visual quality910.…”

“…However, another study reports that bifocal IOLs provide intermediate visual acuity (VA) similar to trifocal IOLs2. Other studies suggest that the diffractive design of trifocal IOLs splits more incoming light than bifocal IOLs, which has the potential to decrease contrast sensitivity and increase photic phenomena19. To our knowledge, no systematic review and meta-analysis has been reported on this topic.…”

Retreatments after multifocal intraocular lens implantation: an analysis

“…Modern multifocal IOLs share similar optical properties when tested on a bench, although each has a unique pattern for distributing light to far, near, and (for trifocal IOLs) intermediate foci. 20 Results here suggest that patient factors, particularly residual refractive error, are the most important drivers of the retreatment rate with these lenses.…”