Effect of Violet Light-Filtering and Manufacturing Improvements in an Extended Depth-of-Focus Intraocular Lens on Visual Performance

Abstract

Purpose

To assess the experimental visual performance and dysphotopsia characteristics of the new Tecnis Symfony OptiBlue extended-depth-of-focus with violet light-filtering (ZXR00V) intraocular lens (IOL) compared with the colorless Tecnis Symfony (ZXR00) IOL.

Methods

Range of vision was assessed with simulated visual acuity defocus curves, predicted by white light through focus modulation transfer function (MTF) measurements. The clinical visual acuity defocus curve of the ZXR00 IOL was used to validate the predicted range of vision. Image quality was compared by measuring white light MTF at a spatial frequency of 15 cycles per degree (c/deg) for 3 mm and 5 mm pupil diameters with optical powers of 5 D, 20 D, and 34 D using the average corneal eye (ACE) model with the average spherical and chromatic aberration of the cataract population. Effects on dysphotopsias were predicted by measurement and computer simulation of light scatter (straylight parameter) and subsequent determination of retinal veiling luminance (RVL) in vitro. Contrast enhancement under challenging light conditions was calculated based on the effects in RVL.

Results

The simulated visual acuity defocus curves and image quality outcomes were comparable between the ZXR00V and ZXR00 IOLs. The area under the straylight curve for the straylight parameter showed a 19% improvement in halo performance with ZXR00V versus ZXR00. A 12% to 17% reduction in RVL was achieved in favor of ZXR00V over ZXR00, which enhanced contrast vision by 9% to 13% under challenging light conditions

Conclusion

The violet light-filtering technology and improved manufacturing of ZXR00V delivers a comparable range of vision and tolerance to refractive error to ZXR00 while mitigating dysphotopsias and enhancing contrast vision.

Keywords:

• dysphotopsia profile
• presbyopia-correcting IOL
• retinal veiling luminance
• straylight parameter
• violet light-filtering IOL

Abbreviations

ACE, average corneal eye; EDF, extended depth-of-focus; IOL, intraocular lens; Lb, background luminance; Lt, luminance target; MTF, modulation transfer function; MTFa, area under the modulation transfer function curve; RVL, retinal veiling luminance.

Acknowledgments

Medical writing assistance was provided by Bridget Healy, MBChB, MPH (ApotheCom, Yardley, PA) and was funded by Johnson & Johnson Surgical Vision, Inc.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Marrie van der Mooren, Aixa Alarcon, and Mark D Jenkins Sanchez are employees of Johnson & Johnson Surgical Vision, Inc. Daniel H. Chang is an investigator and consultant for Johnson & Johnson Surgical Vision, Inc., and an investigator for AcuFocus. He reports grants, personal fees, non-financial support from Johnson & Johnson Vision and grants from Acufocus, Inc, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was funded by Johnson & Johnson Surgical Vision, Inc., which participated in the design and conduct of the study.