Image Quality of the Eye with a Premium IOL: Simulation of the Retinal Surgeon’s View

The quality of the image viewed through premium intraocular lenses (IOLs) was evaluated. Refractive or diffractive multifocal IOLs or toric IOLs were placed in a fluid-filled model eye. A US Air Force resolution target was placed on the posterior surface of the model eye. A flat contact lens or a wide-angle viewing contact lens was placed on the cornea. The contrasts of the gratings were evaluated under endoillumination and compared to those obtained through a monofocal IOL. The images were clear when viewed with flat contact lens through the central far-vision zone of refractive multifocal IOLs although those through the near-vision zone were blurred. The images observed with flat contact lens through the diffractive area were slightly defocused in the center, but the images through the peripheral diffractive area were very blurred. The images were less blurred with the wide-angle viewing contact lens. The contrast of the targets viewed with the flat contact lens through toric IOLs was lower than that viewed through non-toric IOL but not with the wide-angle viewing lens. The vertical (against the flat meridian axis) length of the target with a flat contact lens was longer and the horizontal length was shorter than that through non-toric IOL, but was not different with the wide-angle viewing lens. Based on these studies, the wide-angle viewing system is recommended to be used for eyes implanted with multifocal and toric IOLs.