title: Simulated prototype of posterior chamber phakic intraocular lens for presbyopia correction.
abstract: OBJECTIVE
  To evaluate the visual impact of adding different spherical aberration values to an Implantable Collamer Lens phakic intraocular lens (pIOL) to increase the depth of focus using an adaptive optics visual simulator.
  
  
  METHODS
  University of Valencia, Valencia, Spain.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Wavefront aberrations in -3.00 D and -6.00 diopter (D) pIOLs were measured in vitro. Afterward, different simulated pIOL experimental prototypes were created along with variances in the spherical aberration. An adaptive optics visual simulator was used to simulate vision after the implantation of the different pIOL prototypes from their wavefront aberrations. The corrected distance visual acuity (CDVA) and depth of focus were measured in 3.0 and 4.5 mm pupils.
  
  
  RESULTS
  In a 3.0 mm pupil, the CDVA achieved with -3.00 and -6.00 D pIOLs and all pIOL prototypes evaluated was above 20/20 except for a -6.00 D pIOL + spherical aberration 4 at 50% CDVA contrast, which decreased to 20/25. However, in a 4.5 mm pupil, the CDVA obtained with the pIOL prototypes decreased significantly and was more pronounced when the spherical aberration induced was negative. The depth of focus increment was larger with the highest spherical aberration added and with a small pupil. Nevertheless, it was independent of the sign of the added spherical aberration.
  
  
  CONCLUSIONS
  The outcomes show that residual negative spherical aberration after pIOL implantation will disrupt the CDVA. However, some residual positive spherical aberration after pIOL implantation increased the depth of focus with excellent CDVA, providing a possible pIOL design for young presbyopic patients.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From Grupo de Investigación en Optometría, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain. Electronic address: cari.perez@uv.es.
authors.forename: Cari
authors.initials: C
authors.lastname: Pérez-Vives
authors.affiliation: From Grupo de Investigación en Optometría, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Ferrer-Blasco
authors.affiliation: From Grupo de Investigación en Optometría, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Cerviño-Expósito
authors.affiliation: From Grupo de Investigación en Optometría, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Madrid-Costa
authors.affiliation: From Grupo de Investigación en Optometría, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain.
authors.forename: Robert
authors.initials: R
authors.lastname: Montés-Micó
mesh_terms: D000328:Adult; D003198:Computer Simulation; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D003867:Depth Perception / Q000502:physiology*; D003941:Diagnostic Techniques, Ophthalmological; D006801:Humans; D019654:Lens Implantation, Intraocular; D054120:Phakic Intraocular Lenses; D011305:Presbyopia / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011680:Pupil / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult