Subjective and objective refractions in eyes with extended‐depth‐of‐focus intraocular lenses using echelette optics: clinical and experimental study

Abstract

Purpose To evaluate differences in subjective and objective refractions in eyes with extended‐depth‐of‐focus intraocular lenses (EDOF IOLs) using echelette optics, and the effect of the light wavelength used during examinations. Methods In the prospective study, subjective and objective refractions of 128 eyes of 64 patients were examined 3 months after implantation of the EDOF IOLs (ZXR00V, Johnson & Johnson Surgival Vision). Objective refractions were measured using an autorefractor with a near‐infrared (NIR) light source. Clinical differences in the spherical, cylindrical and spherical equivalent (SE) refractions between the subjective and objective refractions were evaluated. Then, lens powers of monofocal, EDOF and diffractive bifocal IOLs in the use of a 850‐nm light source were measured experimentally for using a lensmeter, and the differences from the monofocal IOLs were calculated. Results The mean objective refractions were more myopic (p < 0.001) than the subjective refractions; the differences in the spherical, cylindrical and SE refractions were −0.71, −0.26 and −0.84 dioptre, respectively. Experimental investigation resulted that there was the mean difference of 0.83 D with the EDOF from monofocal IOLs at 850 nm, while the difference was −0.20 D with bifocal IOLs. Conclusions The diffractive EDOF IOLs using echelette gratings inherently induced constant differences in the subjective and objective refractions, which arose from the chromatic difference in IOL powers for the visible and NIR lights.

Comparative analysis of visual outcome with 3 intraocular lenses: monofocal, enhanced monofocal, and extended depth of focus

“…This discrepancy had previously been reported in the literature and should be attributed to different lens geometries, which, in turn, influence the objective measurement of autorefractometers. 23 Distance visual outcome was, as expected, excellent for each IOL: every patient reached binocular UDVA superior to 0.1 logMAR (20/25), with at least 80% gaining 0.0 logMAR (20/20) or more (Figure 4). Binocular UIVA, which might at best reproduce real-world intermediate visual outcome, was similar for both Eyhance and Symfony (Supplemental Table 1, http://links.lww.com/JRS/A386).…”

“…This discrepancy had previously been reported in the literature and should be attributed to different lens geometries, which, in turn, influence the objective measurement of autorefractometers. 23…”

Visual outcomes of non-diffractive extended-depth-of-focus and enhanced monofocal intraocular lenses: A case-control study

“…In contrast, many authors have reported differences in the objective and subjective refractions of eyes implanted with the Tecnis Eyhance and Tecnis Symphony IOLs due to different optic designs. 9,13,14 We found no such difference in our study with either the Eyhance or the AcrySof IQ Vivity IOLs.…”

Update Biometrie und Linsenberechnung – ein Review zu Grundlagen und neuen Entwicklungen

“…Bei diffraktiven IOLs, die in die chromatische Aberration eingreifen, ist das Weglassen eines Rot-Grün-Abgleichs zu bedenken. Eine Autorefraktion sollte aus genannten Gründen und der Problematik des Umrechnens des Infrarotfokus auf sichtbares Licht (Abbé-Zahl der Linse) nicht zum Einsatz kommen 19 , 20 .…”

“…For diffractive IOLs that have an impact on chromatic aberration, the omission of red-green matching should be considered. Autorefraction should not be used for the reasons mentioned, and due to the problem of converting the infrared focus to visible light (Abbe number of the lens) 19 , 20 .…”