Spectral Effects and Range of Focus in a Multizonal-Refractive Intraocular Lens Compared with a Standard Trifocal Diffractive Design

Abstract

Introduction: This study was performed to compare the optical performance of a multizonal presbyopia-correcting intraocular lens (IOL) and a conventional trifocal model. Methods: The optical quality and simulated visual acuity (VA) of 570 Precizon Presbyopic NVA (OPHTEC BV) and AcrySof IQ PanOptix (Alcon) were compared. The Precizon features a refractive design consisting of alternating optical zones that converge the incident light into two principal foci and a transitional zone for intermediate vision. By contrast, the PanOptix applies a diffractive (non-apodized) profile to achieve trifocality. Simulated VA was derived from the modulation transfer function. Chromatic aberration effects were also studied. Results: The diffractive and multizonal-refractive lenses yielded comparable simulated VAs at far focus (0.00 logMAR). All curves showed a reduction in expected VA with an increase in negative defocus. At -1.0 D, the multizonal-refractive IOL's VA dropped by 0.05 logMAR, but for the diffractive model, it was one line (0.11 logMAR). The multizonal-refractive lens's VA prediction at the secondary peak was 0.03 logMAR-minimally better than the 0.06 log-MAR of the diffractive lens at -2.5 D. The refractive lens exhibited a 24% decrease in polychromatic optical quality due to material dispersion. The performance of PanOptix was more substantially affected, showing a 44% loss at 50 lp/mm at far, with minimal effects at other distances. Conclusion:The multizonal-refractive lens does not fall short of the established trifocal IOL, and it can be used to extend the visual range of pseudophakic patients. Although the multizonal-refractive lens has lower material dispersion, the diffractive model corrects chromatism beyond far focus.

Analysis of the Visual Function With the Continuous Transitional Focus Intraocular Lens Precizon Presbyopic

“…However, the corrected-distance visual acuities measured with the defocus curve for vergence demands simulating close distances showed a positive correlation with mesopic pupil diameter, indicating that these visual acuities became worse for larger pupil sizes. This is consistent with optical bench studies [1,4] showing almost full pupil independence of the refractive multi-segmented IOL evaluated for photopic pupil sizes, but a slight progressive worsening of the MTF as the mesopic pupil size was larger, especially for the most negative vergence demands (simulating the closest distances). This contrasts with other presbyopia-correcting or EDOF IOLs showing a clearly higher pupil-dependence of the visual outcomes compared to Precizon Presbyopic IOL [18][19][20][21][22].…”

“…This IOL, with the commercial brand name of Precizon Presbyopic NVA (Ophtec BV, Groningen, The Netherlands), is a multizonal-refractive lens that combines different segments in the optical zone of the IOL providing distance and near vision correction with a smooth transition between them. An experimental study has also demonstrated that this multizonal-refractive IOL has a lower level of decrease in polychromatic optical quality due to material dispersion compared to a widely implanted trifocal diffractive IOL [4]. Some previous clinical studies have shown that the implantation of Precizon Presbyopic IOL is a safe and effective method to provide good visual acuity at all distances in presbyopic and cataract patients [5][6][7][8].…”