Purpose: To compare the resolution and optical quality of the ReSTOR (R) +3.0 D and ReSTOR+2.5 D multifocal intraocular lenses (IOLs) with the AT LISA (R) tri and FineVision (R) trifocal IOLs.Methods: Resolution, image quality, and photic phenomena were evaluated in the AcrySof (R) IQ ReSTOR +3.0 D and +2.5 D multifocal IOLs and compared with the AT LISA tri 839MP and FineVision Micro F12 trifocal IOLs, using a Badal optometer and a Snellen visual acuity chart. Simulated headlight images were obtained using a modulation transfer function (MTF) bench and a 50 mu m pinhole target. MTF values, using vertical and horizontal slits, were determined at far, intermediate, and near distances.Results: Resolution at 20/40 Snellen visual acuity equivalence was attainable over nearly the entire viewing distance range with the AT LISA tri and FineVision IOLs, but background shadows were more prominent with the AT LISA tri and FineVision IOLs than with the ReSTOR IOLs. Distance MTF peaks at 20/20 Snellen-equivalent spatial frequency were greatest for ReSTOR +2.5 D and ReSTOR +3.0 D IOLs. The near MTF peak occurred at 53 cm with ReSTOR +2.5 D and had a 20/20 Snellen-equivalent value that was lower than the near peaks of the other models but higher than the intermediate foci of the trifocal IOLs.Conclusion: AT LISA tri and FineVision trifocal IOLs achieved a useful third focus for intermediate vision but were associated with increased background halos and reduced distance visual quality compared with ReSTOR +2.5 D and +3.0 D multifocal IOLs.

PURPOSE:To study the etiology of surface light scattering on hydrophobic acrylic intraocular lenses (IOLs). SETTING:Alcon Research Laboratories, Fort Worth, Texas, USA. DESIGN:Experimental study. METHODS:Intraocular lenses were obtained from clinical explantations (n = 5), from human cadavers (n = 8), and from finished-goods inventory (controls). Surface light scattering was measured and imaged with the IOLs in various hydration states (dry, short-term wetted, and long-term hydrated) before and after proteins were quantified and removed. Selected IOL samples were analyzed with x-ray photoelectron spectroscopy, scanning electron microscopy (SEM) with energy-dispersion x-ray analysis, Fourier-transform infrared spectroscopy with attenuated total reflectance, and cryogenic SEM with a focused ion beam. RESULTS:No inorganic deposits or organic changes were observed on any IOL surface. Under clinically relevant hydrated conditions, surface light-scattering intensity was independent of proteinaceous biofilm state (P≥.11). Instead, the hydration state of the IOLs significantly contributed to the intensity of surface light scattering (P<.001); clinically explanted and cadaver-eye IOLs (but not control IOLs) exhibited minimal scatter when dry, intermediate scatter when wetted, and maximum scatter when hydrated. Subsurface nanoglistenings with diameters less than a micron and with locations up to 120 μm from the surface of the IOLs were characterized by SEM with a focused ion beam and were identified as the source of the hydration-related surface light scattering. CONCLUSION:Surface light scattering on hydrophobic IOLs was predominantly caused by hydration-related subsurface nanoglistenings within the acrylic IOL material.

La presente invention concerne, de maniere generale, des lentilles intraoculaires (IOL) accommodatives qui presentent une aberration spherique dynamique en fonction du pouvoir d'accommodation. A titre d'exemple, selon un aspect, la presente invention concerne une lentille intraoculaire (IOL) comportant un element optique anterieur, un element optique posterieur, et un mecanisme pour coupler les elements optiques anterieur et posterieur de maniere a permettre le mouvement axial de ces elements l'un par rapport a l'autre et a permettre l'accommodation quand la lentille est implantee dans l'œil d'un patient. Chacun des elements anterieur et posterieur comprend au moins une surface aspherique, les asphericites des surfaces etant adaptees pour creer une aberration spherique combinee qui varie en fonction de l'accommodation.