Impact of corneal aberrations on through-focus image quality of presbyopia-correcting intraocular lenses using an adaptive optics bench system.
OBJECTIVE
To measure the impact of corneal aberrations on the through-focus image quality of presbyopia-correcting intraocular lenses (IOLs) using an adaptive optics IOL metrology system.


METHODS
Flaum Eye Institute, University of Rochester, Rochester, New York, USA.


METHODS
Experimental study.


METHODS
An adaptive optics IOL metrology system comprising a model eye, wavefront sensor, deformable mirror, and an image-capturing device acquired through-focus images of a letter chart with 3.0 mm and 5.0 mm pupil diameters. The system was used to induce corneal astigmatism and higher-order aberrations (HOAs) in previously measured pseudophakic presbyopic eyes. A single-optic accommodating IOL (Crystalens HD (HD500), an apodized (Restor +3.0 diopter [D] SN6AD1) and full-aperture (Tecnis ZM900) diffractive multifocal IOL, and a monofocal IOL (Acrysof SN60AT) were evaluated. Image quality was quantified using the correlation-coefficient image-quality metric.


RESULTS
The single-optic accommodating IOL and monofocal IOL performed similarly; however, with a 3.0 mm pupil, the former had better intermediate (1.50 D) image quality. The multifocal IOLs had bimodal through-focus image quality trends. Corneal astigmatism reduced through-focus image quality and depth of focus with all IOLs; however, the multifocal IOLs had the most severe decline in depth of focus. Ocular spherical aberration had the strongest impact on image quality when typical pseudophakic corneal HOAs were present.


CONCLUSIONS
The uncorrected corneal astigmatism and HOAs in pseudophakic eyes significantly affected through-focus performance of presbyopia-correcting IOLs. Although multifocal IOLs significantly increased depth of focus, this benefit diminished when more than 0.75 D astigmatism remained uncorrected. Residual ocular spherical aberration had a significant effect on image quality in the presence of other corneal HOAs.
Flaum Eye Institute, University of Rochester, Rochester, NY 14624, USA.
Len
L
Zheleznyak
Myoung Joon
MJ
Kim
Scott
S
MacRae
Geunyoung
G
Yoon
D000065:Accommodation, Ocular / Q000502:physiology; D001251:Astigmatism / Q000503:physiopathology; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D003867:Depth Perception / Q000502:physiology; D006801:Humans; D007910:Lenses, Intraocular; D008962:Models, Theoretical; D055095:Optics and Photonics; D011305:Presbyopia / Q000503:physiopathology* / Q000601:surgery; D014785:Vision, Ocular / Q000502:physiology*