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Simulation of decentration and tilt of a sulcus fixated lens in a polypseudophakic combination using optical design software

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First Author: T.Yildirim GERMANY

Co Author(s):    G. Łabuz   H. Son   R. Khoramnia   G. Auffarth           

Abstract Details

Purpose:

To measure the effect of tilt and decentration on the image quality in a two-lens system with a sulcus-fixated intraocular lens (IOL) and a monofocal aspheric in-the-bag IOL using ray-tracing simulations.

Setting:

The David J. Apple International Laboratory for Ocular Pathology, Heidelberg, Germany.

Methods:

Optical simulations were performed with supplementary sulcus-fixated IOLs (Sulcoflex Aspheric, 653L) and an in-the-bag lens (RayOne Aspheric, RAO600C) featuring an aberration neutral design. Besides, a spherical aberration correcting IOL for capsular bag implantation was included for comparison. A model eye was built in OpticStudio (Radiant Zemax LLC). The IOLs were compared according to their image quality metrics utilizing a polychromatic modulation transfer function (MTF) assessed at a 3-mm pupil. The IOLs’ tolerance to decentration (up to 1 mm) in X and Y direction and tilt (up to 7.5 deg) was tested.

Results:

The MTF at 50 lp/mm of perfectly centered 1.75D and 3.50D supplementary lenses in the two- lens system virtually did not change with X=Y=1 mm, as well as under 7.5° tilt. The discrete MTF of the aberration-neutral lens remained unchanged after maximum decentration as well as 2.5° and 5° tilt alone. However, tilt up to 7.5° did affect the optical quality. Simultaneous decentration and tilt of higher degree (i.e., X=Y=1 mm and 7.5°) of the 20D in-the-bag IOLs resulted in a relevant reduction of the MTF level. However, the lens with spherical aberration correction demonstrated lower tolerance to misalignment than one with the aberration-neutral design.

Conclusions:

We demonstrated that tilt and decentration of the Sulcoflex IOLs in pseudophakic configuration have but minimal effect on the MTF. A precise alignment of a high-power capsular bag lens appears to be essential, in both standard single-lens implantation and duet configuration.

Financial Disclosure:

... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a competing company, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a competing company, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a competing company