Psychophysical Vision Simulation of Diffractive Bifocal and Trifocal Intraocular Lenses. 2016

Wolfgang Brezna, and Kirsten Lux, and Nikolaus Dragostinoff, and Christian Krutzler, and Nicole Plank, and Rainer Tobisch, and Agnes Boltz, and Gerhard Garhöfer, and Reinhard Told, and Katarzyna Witkowska, and Leopold Schmetterer
ACMIT Gmbh, Wiener Neustadt, Austria.

OBJECTIVE The visual performance of monofocal, bifocal, and trifocal intraocular lenses was evaluated by human individuals using a vision simulator device. This allowed investigation of the visual impression after cataract surgery, without the need actually to implant the lenses. METHODS The randomized, double-masked, three-way cross-over study was conducted on 60 healthy male and female subjects aged between 18 and 35 years. Visual acuity (Early Treatment Diabetic Retinopathy Study; ETDRS) and contrast sensitivity tests (Pelli-Robson) under different lighting conditions (luminosities from 0.14-55 cd/m2, mesopic to photopic) were performed at different distances. RESULTS Visual acuity tests showed no difference for corrected distance visual acuity data of bi- and trifocal lens prototypes (P = 0.851), but better results for the trifocal than for the bifocal lenses at distance corrected intermediate (P = 0.021) and distance corrected near visual acuity (P = 0.044). Contrast sensitivity showed no differences between bifocal and trifocal lenses at the distant (P = 0.984) and at the near position (P = 0.925), but better results for the trifocal lens at the intermediate position (P = 0.043). Visual acuity and contrast sensitivity showed a strong dependence on luminosity (P < 0.001). CONCLUSIONS At all investigated distances and all lighting conditions, the trifocal lens prototype often performed better, but never worse than the bifocal lens prototype. CONCLUSIONS The vision simulator can fill the gap between preclinical lens development and implantation studies by providing information of the perceived vision quality after cataract surgery without implantation. This can reduce implantation risks and promotes the development of new lens concepts due to the cost effective test procedure.

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