Purpose: To assesses the link between the in vitro optical properties of the PODFGF multifocal intraocular lens (IOL) and its visual acuity (VA) clinical performance. Setting: The study was conducted at TUDelft (NL), ULiege (BE), the Rothschild Institute (FR), and Beaver-Visitec International (BE). Design: The study analyzed 3 powers of the PODFGF IOL. The in vitro imaging quality was assessed using modulation transfer function (MTF) frequency sweep and through-focus MTF. Multiple figures of merit (FOMs), including MTF at 25-50-100 LP/mm, MTFa, and Strehl ratio, were extracted. Data acquisitions followed 2 ISO norms in green and white light conditions. The correlation with patients’ clinical VA was evaluated. Methods: The methodology had 2 parts: first, characterizing the in vitro properties of the IOL using FOMs, such as MTF, MTFa, and Strehl ratio, with multiple power samples (6 to 35 diopters). The second part analyzed the VA of 413 eyes implanted with FINEVISION-HP (PODFGF). Over 2 years, subjective refraction, uncorrected distance VA, corrected distance VA, uncorrected intermediate VA, distance-corrected intermediate VA, uncorrected near VA, distance-corrected near VA, defocus curve, photopic and mesopic contrast sensitivity, and rotational stability were analyzed. Results: The correlation between in vitro MTFa evaluated from the experimental data on IOLs and the clinical VA performed on implanted patients leads to an accurate prediction of vision capabilities after surgery. Conclusions: This study clinically demonstrates on a large patient cohort that MTFa complements single-frequency MTFs and establishes a mathematical link between MTF at 50 LP/mm, MTFa, and VA. In addition, it connects the 2 ISO model-eye standards and highlights the link between green and white light measurements in accurately predicting VA.

Purpose: Most optical systems present chromatic aberration quantified along the optical axis by the longitudinal chromatic aberration (LCA). LCA is controlled by the biomaterial Abbe number combined with diffractive effects, driven by the intraocular lens (IOL) topography. This study experimentally aimed at describing the effect in vitro of LCA in diffractive multifocal IOLs, with the help of dedicated optical benches and topographic characterization. Setting: Centre Spatial de Liège, Belgium. Design: Optical and topology analysis of various multifocal diffractive IOLs. Methods: Seven diffractive multifocal IOLs, available on the market and exhibiting different diffractive profiles, made from various biomaterials, were characterized under different wavelengths. Results: Through-focus modulation transfer function (MTF) curves and IOL diffraction efficiency depends on the incident light wavelength. In this study, the topology properties of various multifocal IOLs were investigated and their characteristics were correlated to their optical behavior for various wavelengths. Chromatic properties and their origins were then compared. As expected, diffractive and refractive effects were found to act in opposite ways, and could be partially or completely compensated. Conclusions: The LCA of each of the IOLs was evaluated in vitro. In most of the multifocal IOLs studied, some of the foci were found to be refractive, whereas others were diffractive. Although the results were not extrapolated to clinical relevance, it was shown, in some of the cases, that LCA could be fully compensated.

PURPOSE: To experimentally compare the optical performance of three types of hydrophobic intraocular lenses (IOLs): extended depth of focus, bifocal, and trifocal. METHODS: The tested IOLs were: TECNIS ZMB00 (bifocal; Abbott Medical Optics, Abbott Park, IL), TECNIS Symfony ZXR00 (extended depth of focus; Abbott Medical Optics), and FineVision GFree hydrophobic (trifocal; PhysIOL, Liege, Belgium). Their surface topography was analyzed by optical microscopy. Modulation transfer function (MTF) and spherical aberrations were determined on optical bench for variable pupil apertures and with two cornea models (0 fÊm and +0.28 fÊm). United States Air Force target imaging was analyzed for different focal points (near, intermediate, and far). Point spread function (PSF) and halos were quantified and compared. RESULTS: The three lenses presented step-like optic topography. For a pupil size of 3 mm or greater, clearly distinctive MTF peaks were observed for all lenses: two peaks for the extended depth of focus and bifocal lenses with +1.75 and +4.00 diopters (D) addition, respectively, and three peaks for the trifocal lens with +1.75 and +3.50 addition for intermediate and near vision, respectively. The extended depth of focus and bifocal lens had slightly higher MTF at best focus with the +0.28 fÊm cornea model than with the 0 fÊm model, whereas the trifocal lens was likely to be more independent of the corneal spherical aberrations. CONCLUSIONS: It appears that the three lenses rely on light diffraction for their optical performance, presenting halos with comparable intensities. For small pupil apertures (< 3 mm), the MTF peaks for the far and intermediate focal distances of the trifocal and extended depth of focus lenses overlap, but the trifocal lens presented an additional MTF peak for the near focal points.