Article
Two phakic intraocular lenses in correction of presbyopia: objective evaluation and comparison
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Authors
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Niknahad A. Zielinska
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg
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Z. Wu
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg
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H.-S. Son
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg
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G. Labuz
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg
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G.U. Auffarth
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg
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R. Khoramnia
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg
| Published: | June 3, 2025 |
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Outline
Text
Purpose: While phakic intraocular lenses (IOLs) have been extensively studied for refractive-error treatment, investigations evaluating and comparing phakic IOLs mitigating the effects of presbyopia are limited. This study aimed to assess two types of phakic IOLs – a diffractive IPCL (Care Group) with +2.5D added power and a refractive ArtiPlus (Ophtec) – by measuring modulation transfer functions (MTF), related optical variables, and the 1951 USAF resolution target images.
Methods: A custom-made insert contained a simulated natural lens (23D monofocal Precision Monofocal, Ophtec) posteriorly and a -3D phakic IOL anteriorly. The optical quality of two samples of each phakic IOL was measured using Laboratory’s OptiSpheric IOL PRO2 under spherical- and chromatic-aberration conditions. MTF, through-focus area under the MTF curve (TF MTFa), and simulated visual acuity (simVA) were compared at 3.0 and 4.5mm apertures at near (40 cm), intermediate (67 cm), and far distances.
Results: MTF values at far and intermediate distances were similar for both IOLs at 3 mm. Still, the TF MTFa showed a slight improvement in the intermediate range with the ArtiPlus, while the secondary peak of the IPCL, located around 50 cm, exceeded that of its refractive counterpart. These differences, however, translated into only a marginal change in simVA of 0.02 logMAR, with the VA gap between the two lenses increasing slightly to 0.04 logMAR at 40 cm, where the ArtiPlus model demonstrated additional benefits. Both the IPCL and ArtiPlus showed decreased optical quality as the aperture size increased. Although the far and intermediate MTFs were comparable between the two models, the near-focus performance of the diffractive IOL was weaker, with an overall narrower depth of focus compared to the refractive model. Results from the USAF resolution target images supported these findings.
Conclusions: The ArtiPlus and the IPCL (+2.5D add) demonstrated good optical quality across the studied focus range, with the former providing a flatter simulated defocus curve. While expected differences in VA between the two approaches were minimal, they may become more pronounced in patients with larger pupils, warranting further investigation in a clinical setting.
