Correlating Optical Bench Performance With Clinical Defocus Curves in Varifocal and Trifocal Intraocular Lenses

Abstract

Original Article Ana B. Plaza-Puche, MSc; Jorge L. Alió, MD, PhD; Scott MacRae, MD; Len Zheleznyak, PhD; Esperanza Sala, OD; Geunyoung Yoon, PhD To investigate the correlations existing between a trifocal intraocular lens (IOL) and a varifocal IOL using the “ex vivo” optical bench through-focus image quality analysis and the clinical visual performance in real patients by study of the defocus curves. This prospective, consecutive, nonrandomized, comparative study included a total of 64 eyes of 42 patients. Three groups of eyes were differentiated according to the IOL implanted: 22 eyes implanted with the varifocal Lentis Mplus LS-313 IOL (Oculentis GmbH, Berlin, Germany); 22 eyes implanted with the trifocal FineVision IOL (Physiol, Liege, Belgium), and 20 eyes implanted with the monofocal Acrysof SA60AT IOL (Alcon Laboratories, Inc., Fort Worth, TX). Visual outcomes and defocus curve were evaluated postoperatively. Optical bench through-focus performance was quantified by computing an image quality metric and the cross-correlation coefficient between an unaberrated reference image and captured retinal images from a model eye with a 3.0-mm artificial pupil. Statistically significant differences among defocus curves of different IOLs were detected for the levels of defocus from −4.00 to −1.00 diopters (D) (P < .01). Significant correlations were found between the optical bench image quality metric results and logMAR visual acuity scale in all groups (Lentis Mplus group: r = −0.97, P < .01; FineVision group: r = −0.82, P < .01; Acrysof group: r = −0.99, P < .01). Linear predicting models were obtained. Significant correlations were found between logMAR visual acuity and image quality metric for the multifocal and monofocal IOLs analyzed. This finding enables surgeons to predict visual outcomes from the optical bench analysis. [J Refract Surg. 2015;31(5):300–307.] From Vissum Corporation, Alicante, Spain (ABP-P; JLA, ES); Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain (JLA); Flaum Eye Institute, University of Rochester, Rochester, New York (SM, LZ, GY); The Institute of Optics, University of Rochester, Rochester, New York (SM, LZ, GY). Supported by Research to Prevent Blindness, Inc., the National Institute of Health (R01EY014999), and University of Rochester NYSTAR Center for Advanced Technology/Center for Emerging and Innovative Sciences. Supported in part by a grant from the Spanish Ministry of Health, Instituto Carlos III, Red Temática de Investigación cooperativa en Salud “Patología ocular del envejecimiento, calidad visual y calidad de vida”, Subproyecto de Calidad Visual (RD07/0062), and a grant from the Spanish Ministry of Economy and Competitiveness, Instituto Carlos III, Red Temática de investigación Cooperativa en Salud(RETICS) “Prevención, detección precoz y tratamiento de la patología ocular prevalente, degenerativa y crónica,” Subprograma “dioptrio ocular y patologías frecuentes” (RD12/0034/0007) (Yoon). The authors have no financial or proprietary interest in the materials presented herein. AUTHOR CONTRIBUTIONS Study concept and design (ABP-P, JLA, SM); data collection (ABP-P, JLA, LZ, ES, GY); analysis and interpretation of data (ABP-P, LZ, GY); writing the manuscript (ABP-P, LZ, ES); critical revision of the manuscript (JLA, SM, GY); statistical expertise (ABP-P); administrative, technical, or material support (JLA, ES); supervision (JLA, SM, LZ, GY) Correspondence: Jorge L. Alió, MD, PhD, Avda de Denia s/n, Edificio Vissum, 03016 Alicante, Spain. E-mail: jlalio@vissum.com To investigate the correlations existing between a trifocal intraocular lens (IOL) and a varifocal IOL using the “ex vivo” optical bench through-focus image quality analysis and the clinical visual performance in real patients by study of the defocus curves. This prospective, consecutive, nonrandomized, comparative study included a total of 64 eyes of 42 patients. Three groups of eyes were differentiated according to the IOL implanted: 22 eyes implanted with the varifocal Lentis Mplus LS-313 IOL (Oculentis GmbH, Berlin, Germany); 22 eyes implanted with the trifocal FineVision IOL (Physiol, Liege, Belgium), and 20 eyes implanted with the monofocal Acrysof SA60AT IOL (Alcon Laboratories, Inc., Fort Worth, TX). Visual outcomes and defocus curve were evaluated postoperatively. Optical bench through-focus performance was quantified by computing an image quality metric and the cross-correlation coefficient between an unaberrated reference image and captured retinal images from a model eye with a 3.0-mm artificial pupil. Statistically significant differences among defocus curves of different IOLs were detected for the levels of defocus from −4.00 to −1.00 diopters (D) (P < .01). Significant correlations were found between the optical bench image quality metric results and logMAR visual acuity scale in all groups (Lentis Mplus group: r = −0.97, P < .01; FineVision group: r = −0.82, P < .01; Acrysof group: r = −0.99, P < .01). Linear predicting models were obtained. Significant correlations were found between logMAR visual acuity and image quality metric for the multifocal and monofocal IOLs analyzed. This finding enables surgeons to predict visual outcomes from the optical bench analysis. [J Refract Surg. 2015;31(5):300–307.] From Vissum Corporation, Alicante, Spain (ABP-P; JLA, ES); Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain (JLA); Flaum Eye Institute, University of Rochester, Rochester, New York (SM, LZ, GY); The Institute of Optics, University of Rochester, Rochester, New York (SM, LZ,...