gms | German Medical Science

Purpose: The optical quality of intraocular lenses (IOLs) is typically tested according to ISO-11979-2. However, its recommendation on the use of monochromatic light for image quality testing may not fully represent real-world conditions. This study aimed to assess three Extended Depth-of-Focus (EDoF) IOLs and a monofocal control in polychromatic light.

Methods: The following EDoF models were studied: LuxSmart (Bausch & Lomb), SymfonyZXR00 (Johnson & Johnson Vision), and AT Lara 829 MP (Carl Zeiss Meditec). The monofocal lens was AcrySof IQ SN60WF (Alcon Inc.). Polychromatic optical performance was assessed using white light with a photopic-eye-response filter. The weighted optical transfer function (wOTF), derived from the modulation transfer function and the phase transfer function of the studied IOLs and weighted by neural contrast sensitivity, was compared. A polychromatic point spread function (PSF) was used to assess the light distribution and identify spurious light.

Results: The wOTF at the best far-focus was better in the SN60WF than in the other IOLs. However, at about –0.75D, the EDoF technology demonstrated improved tolerance. The Symfony and the AT Lara's wOTF revealed two peaks at –1.50D and at zero defocus. By contrast, the LuxSmart's performance was steady for an extended range, which was robust under –1D. The low-light intensity evaluation revealed a slightly extended light spread of the LuxSmart compared to the monofocal lens. The two diffractive lenses demonstrated an area of excessive light intensity around the PSF center.

Conclusion: A non-diffractive LuxSmart appears to provide an EDoF effect without sharp changes in the optical quality, which contrasts with the performance of the Symfony and the Lara. Unlike the two diffractive lenses, the LuxSmart produces unwanted photic effects at a level close to that of a monofocal lens.