Optical Quality Evaluation And Vision Simulation Of A Binocular Diffractive Multifocal Intraocular Lens System Vs. A Conventional Diffractive Multifocal Intraocular Lens

In the binocular diffractive multifocal intraocular lens (IOL) system Artis Symbiose (Cristalens Industrie, France), in addition to the distance focus, one lens features an extended depth of focus profile for intermediate vision (Artis MID) and the other lens for near vision (Artis PLUS). We performed a laboratory study to evaluate the optical quality of the Artis Symbiose IOL system in comparison with a conventional diffractive multifocal IOL AcrySof IQ PanOptix (Alcon, TX, USA), and to simulate binocular vision with the study IOLs.

The David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany

The Artis MID and Artis PLUS IOLs were compared with the AcrySof IQ PanOptix IOL using an optical bench setup. Modulation transfer function and phase transfer function were obtained within the defocus range of +0.75D to -4.0D at spectacle plane in polychromatic light at the aperture of 3 mm using a model cornea with positive spherical aberration. Simulated visual acuity (VA) values were derived from the optical transfer function weighted by the neural contrast sensitivity. The United States Air Force (USAF) resolution chart images were acquired and processed to simulate binocular vision.

All the studied IOLs had a simulated VA of 0.2 logMAR or better throughout the range of +1D to -3D. The peak simulated VA values of the Artis MID were at 0D of defocus (-0.02 logMAR) and at -1.5D (0.00 logMAR); of the Artis PLUS, they were at 0D of defocus (-0.01 logMAR) and at -2.5D (0.01 logMAR). The AcrySof IQ PanOptix demonstrated three peaks: at 0D of defocus (-0.02 logMAR), at -1.75D (0.03 logMAR) and at -2.5D (0.02 logMAR). The binocular summation of the USAF chart images in the simulated binocular system indicated comparable results to those of the AcrySof IQ PanOptix. However, at a defocus of 1.0D and -1.5D, the combination of the Artis MID and the Artis PLUS produced a slightly better image quality.

The binocular multifocal IOL system may yield better intermediate VA and wider defocus range in binocular vision compared to monocular implantation of the conventional multifocal IOL. However, more research is needed to better understand the effect of binocular summation in the binocular multifocal IOL system and in bilateral conventional multifocal IOL implantation.