To evaluate the optical quality of Acrysof Restor SN6AD1 refractive-diffractive +3.00 D and Lentis Mplus LS-312 nonrotational symmetric +3.00 D aspheric multifocal intraocular lenses (IOLs) and analyze the effect of tilt and decentration. University of Valencia, Valencia, and University of Murcia, Murcia, Spain. Experimental study. An artificial model eye was used to measure wavefront aberrations of both IOL models. The modulation transfer function (MTF) and point-spread function (PSF) were calculated for a 5.0 mm pupil and under 5 situations: centered, 0.2 mm and 0.4 mm decentered, and 2 degrees and 4 degrees tilted. The refractive-diffractive IOL had the highest MTF values at all spatial frequencies. Similarly, the PSF was worse for the refractive-diffractive IOL. The MTFs for the refractive-diffractive IOL decreased when the IOL was decentered or tilted, being more robust for tilting than decentration. The MTFs for the nonrotational symmetric IOL were similar under all testing conditions. Cutoff frequencies for the refractive-diffractive IOL were stable over the range of tilting studied and comparable with the cutoff when the IOL was centered (approximately 50 cycles per degree [cpd]). When the IOL was decentered, the cutoff frequency decreased by approximately 40 cpd. The nonrotational symmetric IOL cutoff frequencies for misalignment and tilt were low (approximately 30 cpd) and similar under all conditions. The refractive-diffractive IOL provided better optical quality than the nonrotational symmetric IOL. Tilt and decentration had a significant impact on optical quality with both IOLs, being more severe with the nonrotational symmetric IOL.

Ocular optics is normally estimated based on up to 2,600 measurement points within the pupil of the eye, which implies a lateral resolution of approximately 175 µm for a 9 mm pupil diameter. This is because information below this resolution is not thought to be relevant or even possible to obtain with current measurement systems. In this work, we characterize the in vivo ocular optics of the human eye with a lateral resolution of 8.6 µm, which implies roughly 1 million measurement points for a pupil diameter of 9 mm. The results suggest that the normal human eye presents a series of hitherto unknown optical patterns with amplitudes between 200 and 300 nm and is made up of a series of in-phase peaks and valleys. If the results are analysed at only high lateral frequencies, the human eye is also found to contain a whole range of new information. This discovery could have a great impact on the way we understand some fundamental mechanisms of human vision and could be of outstanding utility in certain fields of ophthalmology.

PURPOSE: To compare differences in induced aberrations and visual acuity after wavefront-optimized LASIK and aspheric-customized LASIK for the treatment of hyperopia. METHODS: Forty consecutive eyes underwent uneventful LASIK for treatment of moderate hyperopia (+3.82 ± 0.63 diopters [D] [+2.75; +5.125]). A standard procedure was performed in the wavefront-optimized LASIK group (n = 24), whereas a postoperative Q-factor equal to zero was scheduled in the aspheric-customized LASIK group (n = 16). RESULTS: At 6 months, mean spherical aberration for a 6-mm pupil diameter was −0.39 ± 0.23 µ m (range: −0.76 to 0.01 µ m) and Q-factor was −0.52 ± 0.22 (range: −1.00 to −0.12 µ m) in the wavefront-optimized group and 0.04 ± 0.18 µ m (range: −0.34 to 0.29 µ m) and −0.04 ± 0.25 (range: −0.64 to 0.40 µ m) in the aspheric-customized LASIK group ( P ≤ .05). All remaining outcomes showed no significant differences between groups. UDVA was 20/18.69 ± 0.15 (range: 0.80 to 1.20) in the wavefront-optimized LASIK group and 20/20 ± 0.17 (range: 0.50 to 1.20) in the aspheric-customized LASIK group. One patient in the wavefront-optimized LASIK group lost two or more lines of CDVA and no lines were lost in the aspheric-customized LASIK group. CONCLUSIONS: The results in this small cases series suggest that using an aspheric-customized ablation profile with a target Q-factor equal to 0 in moderate hyperopic LASIK is statistically compatible with a diminishing induced spherical aberration without altering procedural safety when the WaveLight Allegretto 400-Hz excimer laser platform (Alcon Laboratories, Inc., Fort Worth, TX) is used. [ J Refract Surg. 2015;31(12):802–806.]

PURPOSE: To evaluate visual quality when changing the intraocular orientation of the Lentis Mplus LS-312MF nonrotational symmetric +3.00 diopters aspheric multifocal intraocular lens ([IOL] Oculentis GmbH, Berlin, Germany) in normal eyes. METHODS: An artificial eye was used to measure the in vitro wavefront of the IOL. The corneal topography of 20 healthy patients was obtained. For each eye, a computational analysis simulated the implantation of the IOL. The modulation transfer function (MTF) and an image quality parameter (visually modulated transfer function [VSMTF] metric) were calculated for a 5.0-mm pupil and for three conditions: distance, intermediate, and near vision. The procedure was repeated for each eye after a rotation of the IOL with respect to the cornea from 0° to 360° in 1° steps. RESULTS: Statistical analysis showed significant differences in mean VSMTF values between orientations for distance vision. Optimal orientation of the IOL (different for each eye) showed a mean improvement of 58% ± 19% (range: 20% to 121%) in VSMTF values with respect to the worst possible orientation. For these orientations, intermediate and near vision quality were statistically indistinguishable. The MTFs were different between orientations, showing a mean difference of approximately 5 cycles per degree in the maximum spatial frequencies that can be transferred between the best and the worst orientations for distance vision. CONCLUSIONS: The results suggest that implantation of this nonrotational symmetric IOL should improve visual outcomes if it is oriented to coincide with a customized meridian. A simple, practical method is proposed to find an approximation to the angle that an Mplus IOL should be inserted. [ J Refract Surg. 2015;31(10):651–656.]