The Novel Optical Design and Clinical Classification of a Wavefront-Shaping Presbyopia-Correcting Intraocular Lens

Abstract

Purpose To evaluate the clinical rationale of wavefront-shaping technology, describe how intraocular lenses (IOLs) using wavefront-shaping technology are differentiated from refractive or diffractive optical presbyopia-correcting designs, and describe the mode of action of this technology. Methods Extended depth of focus (EDoF) IOLs are the latest class of presbyopia-correcting IOLs addressing the growing demand of patients for reduced spectacle dependence. These use various optical technologies, including diffractive designs (eg, TECNIS Symfony ZXR00 and AT LARA 29 MP) and non-diffractive designs such as small aperture (eg, IC-8 IOL and XtraFocus Pinhole Implant), spherical aberration (eg, MINI WELL Ready and LuxSmart), and wavefront shaping (eg, AcrySof IQ Vivity DFT015 and Clareon Vivity CNWET0). Despite some improvement in visual acuity at intermediate and near distances, these technologies can still be associated with increased rate of visual disturbances or poorer distance vision compared with monofocal IOLs. One way to overcome such limitations is using a wavefront-shaping optical principle. Results Clinical data show that wavefront-shaping technology results in a continuous EDoF compared with a monofocal IOL while exhibiting a minimal halo, similar to an aspheric monofocal IOL. Clinically, this translates to a lens that has proven to exceed the American National Standards Institute/American Academy of Ophthalmology criteria for an EDoF IOL. Conclusion The novel wavefront-shaping optic technology allows patients to achieve a continuous range of vision from distance to functional near with low levels of visual disturbances comparable with aspheric monofocal IOLs.

The effect of trifocal and extended-depth-of-focus intraocular lenses on optical coherence tomography parameters

“…This IOL has two transition zones to alter the shape of the emergent wavefront, causing the focus point to shift, resulting in a continuous extended focal range. [ 22 ] On the contrary, the monofocal IOLs lead the emergent wavefront to directly focus on the retina forming a concentrated focal point on the retinal plane. [ 22 ] To the best of our knowledge, there are no reports in the literature investigating the effect of the optical properties of the Vivity IOL on OCT parameters.…”

“…[ 22 ] On the contrary, the monofocal IOLs lead the emergent wavefront to directly focus on the retina forming a concentrated focal point on the retinal plane. [ 22 ] To the best of our knowledge, there are no reports in the literature investigating the effect of the optical properties of the Vivity IOL on OCT parameters.…”

Cataract surgery innovations

“…With multiple IOL manufactures in the foray, the advent of newer advances such as proprietary wavefront linking technology aims to provide better far and intermediate ranges with less photopic disturbances compared to traditional monofocal IOLs. [ 12 ]…”