Optical Differentiation of Presbyopia-Correcting Intraocular Lenses With Improved Intermediate Vision From a Single Manufacturer.

Abstract

Purpose: To compare the visual quality metrics of monofocal and presbyopia-correcting intraocular lenses (IOLs) produced by the same manufacturer (Johnson & Johnson Vision).

Methods: This laboratory study analyzed IOLs featuring a TECNIS hydrophobic material, including a monofocal lens (ZCB00), a monofocal lens with improved intermediate vision (Eyhance ICB00), and two different extended-depth-of focus (EDOF) lenses (Symfony and PureSee). An optical bench was used to measure the modulation transfer function (MTF) and United States Air Force (USAF) targets at pupil sizes of 2 to 4.5 mm using polychromatic light and a model cornea with +0.27 µm spherical aberration. Weighted optical transfer function (OTF) was used to simulate the clinical visual acuity and point spread function (PSF) was employed to estimate the light distribution and halo size.

Results: All lenses demonstrated comparable optical quality at far distance with simulated visual acuity better than 0.0 logarithm of the minimum angle of resolution (logMAR). However, at the intermediate distance of 67 cm, distinct differences emerged: the Symfony lens showed a secondary visual acuity peak due to its bifocal design, whereas the PureSee lens outperformed Eyhance lens in simulated visual acuity between -1.00 and -2.00 diopters. The Eyhance and PureSee lenses exhibited pupil-dependent behavior, with a myopic shift in far focus at smaller pupil sizes (< 3 mm), whereas the Symfony lens maintained stable performance. Notably, photic phenomena were minimal for the Eyhance and PureSee lenses and similar to the monofocal ZCB00 lens, whereas the Symfony lens displayed pronounced halos.

Conclusions: Although all lenses performed well at distance, differences in intermediate vision, pupil dependency, and photic phenomena highlight the importance of individualized IOL selection.