Effect of Pupil, Spherical Aberration, Decentration, and Tilt on the Optical Performance of Five Different Monofocal IOLs.

Abstract

Purpose: To evaluate and compare the effect of pupil size, spherical aberration (SA), decentration, and tilt on the optical performance of five different monofocal intraocular lenses (IOLs).

Methods: Four aspheric IOLs (Vivinex, Hoya; SN60WF, Alcon Laboratories, Inc; ZCB00, Johnson & Johnson Surgical Vision; Akreos Adapt AO, Bausch & Lomb) with different SA values and one spherical IOL (SN60AT, Alcon Laboratories, Inc) were tested using an OptiSpheric IOL PRO 2 optical bench. The IOL diopter was measured at different apertures. The optical quality of the IOLs was evaluated using the modulation transfer function (MTF), through-focus MTF, and images of the United States Air Force Target test with different apertures and corneal SA values. The IOLs were also measured while they were decentered and tilted.

Results: The smaller the aperture, the wider the through-focus MTF of all tested IOLs, and the best image quality was observed with a 3-mm aperture. The diopter of aspheric IOLs with negative SA were negatively correlated with aperture size, but the result was opposite for spherical IOLs. The IOL power difference was more than 0.50 diopters between different apertures. All aspheric IOLs had similar MTF curves with a 3-mm aperture. Aspheric IOLs had the best visual quality with the same or similar corneal SAs. Most of the tested IOLs had lower tolerances in tilt than in decentration.

Conclusions: Pupil size, SA value, the degree of decentration, and tilt had different effects on the optical performance of aspheric IOLs. The results can provide guidance for surgeons in clinical practice. [J Refract Surg. 2025;41(3):e220-e230.].