Clinical validation of an adaptive optics instrument for simulation of multifocal IOLs

Session Details

Session Title: Multifocal IOLs and Advanced Optic

Session Date/Time: Tuesday 08/09/2015 | 09:00-10:30

Paper Time: 09:12

Venue: Main Auditorium

First Author: : L.Hervella SPAIN

Co Author(s): :    B. Jaeken   G. Perez   J. Marin   P. Artal           

Abstract Details

Purpose:

Although there are many multifocal intraocular lenses (IOL´s) available, patient's expectations concerning good near vision are not always reached. The clinical use of instruments based on adaptive optics (AO) simulation would help in selecting the optimum IOL for each patient. We evaluated the efficacy of a unique system to simulate different profiles of multifocal IOL´s.

Setting:

Oftalvist, Murcia, Spain / Voptica SL, Murcia, Spain / Laboratorio de Optica, Universidad de Murcia, Murcia, Spain.

Methods:

A commercially available clinical AO based visual simulator (AOnEye, Voptica, Spain), was used. The instrument incorporates an aberrometer, a liquid crystal modulator to induce the profiles and a microdisplay to present the visual stimuli. It was used to evaluate four different IOL's profiles; two diffractive (bifocal and trifocal) and two that induce depth of focus (DOF) by adding spherical aberration (SA) (mild/strong: sphere (S) +0.75/+1.30; SA -0.1/-0.4 microns for 4.5 mm pupil). Through focus decimal visual acuity (VA) was measured at infinity, 100, 66.6, 50, and 33.3 cm in 22 patients (12 young dilated and 10 presbyopic undilated patients).

Results:

The results agreed with theoretical simulations. The bifocal lens showed significant better VA at infinity 0.88 ± 0.22 (mean ± SD) and near 0.78 ± 0.16. The trifocal showed no significant difference between the distances with a mean VA of 0.74 ± 0.16. The mild DOF design showed a good VA for intermediate 0.90 ± 0.18 but showed a decreased performance at far and near (0.69 ± 0.09 and 0.59 ± 0.20 respectively). For the strong DOF VA improvement with decreasing distance (minimum: 0.43 ± 0.14 at far; maximum: 0.86 ± 0.19 at near). Inter-subject preference was detected.

Conclusions:

A clinical adaptive optics visual simulator was proved to be functional to predict clinical visual outcomes of different presbyopic lens profiles. This instrument provides patients the option to show a subjective preference permitting customization/selection of the optimal IOL.

Financial Interest:

One of the authors has significant investment interest in a company producing, developing or supplying product or procedure presented, One of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One of the authors research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, One of the authors is employed by a for-profit company with an interest in the subject of the presentation