EXTENDED DEPTH OF FOCUS WITH INDUCED SPHERICAL ABERRATION

IN LIGHT ADJUSTABLE IOLsPablo Artal, Eloy Villegas, Encarna Alcón,

Inés Yago*, Elena Rubio*, José M. Marín*LABORATORIO DE OPTICA, UNIVERSIDAD DE MURCIA, SPAIN

* Hospital Virgen de la Arrixaca, Murcia, SPAIN

Supported by:

Reserch funding and consulting reimbuserment provided by Calhoun Vision, USA

Light-adjustable intraocular lenses (LALs)* allow nearly

PERFECT refractive outcomes, but also…

customized near vision by extended depth of focus with induced spherical aberration.

*

Defocus (D)-2 -1 0 1 2

1/le

tte

r s

ize

0.10

0.12

0.14

0.16

0.18

0.20

0.22

Spherical aberration increases depth of focus

Defocus (D)-2 -1 0 1 2

1 /

le

tte

r s

ize

0.10

0.12

0.14

0.16

0.18

0.20

0.22

LAL secondary treatments to induce spherical aberration

(asphericity) increasing depth of focus

(See example of LAL full treatment in next slide)

lock-ins

eye’s wave-fronts (examples)

Secondary adjustmentInducing spherical

aberration

Surgery

Two weeks

Primary adjustmentcorrecting defocus

& astigmatism

Patients were implanted bilaterally with LALs

One eye was set to near emmetropia and in the fellow eye negative spherical

aberration was induced

Visual acuity was measured using a computer-assisted procedure both monocularly (each eye separately)

and binocularly

Refraction and spherical aberration measured in each patient with a Hartmann-Shack wavefront sensor

40 cm 30 cm60 cm

and with letters on a micro-display placed at:

Example of induction of negative spherical aberration in LALs

Post-lockin 2Pre-adjusment

Z12=+0.12m Z12 =-0.20m

Myopic M1SA3_60

AsphericF4.7_0.5

> |-0.3| m

BINOCULAR, ONE EYE WITH NEGATIVE SA (sample:4)FAR EYE [-0.75, 0D] [+0.09, +0.25m],

NEAR EYE [-2.25, -1.25D] [-0.08, -0.23m]

DISTANCE (mm)

FAR600400300

VIS

UA

L A

CU

ITY

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

1.1

1.2

20/20

20/40

20/25 J1

J3

20/30 J2

Binocular vision Monocular (“far” eye)Monocular (“near” aspheric eye)

Z12[-0.14,-0.24 m] (sample 4)

Visual acuity as a function of object distance

BINOCULAR, ONE EYE WITH NEGATIVE SA (sample:4)FAR EYE [-0.75, 0D] [+0.09, +0.25m],

NEAR EYE [-2.25, -1.25D] [-0.08, -0.23m]

DISTANCE (mm)

FAR600400300

VIS

UA

L A

CU

ITY

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

1.1

1.2

20/20

20/40

20/25 J1

J3

20/30 J2

Binocular vision

Z12[-0.14,-0.24 m] (sample 4)

Visual acuity as a function of object distance

- The use of the LALs as an advanced and fully customized approach to produce extended depth of focus modifying the eye’s asphericity has been demonstrated.

- In a group of 4 patients, the average binocular visual acuity was 1.1 for far and J1 or better for intermediate and near distances.

- The particular amounts of spherical aberration and defocus can be personalized to maximize quality of vision at all distances.

Conclusions