Imaging Quality of Intraocular Lenses

Purpose: To compare the imaging quality of several commercially available intraocular lenses (IOLs) using the modulation transfer function (MTF) method according to the requirements of the International Standard European Industrial Norm/International Organization for Standardization 11979.

Setting: Universitat für Technik der Informationsverarbeitung, Universität Karlsruhe, Karlsruhe and Universitäts Augenklinik, Ulm, Ulm, Germany.

Methods: Two refractive powers (+13 diopter [D] and +26 D) of each IOL type were tested. The imaging quality of all tested IOLs was measured before the injection test and in 5-minute intervals after the injection for 40 minutes. The measurement data were analyzed according to 2 quality criteria, Strehl ratio and the ISO condition. For analysis of the type of optical design, SEM images of the central cross section were taken of each IOL. Basic terms in optics such as MTF, resolution, and optical aberration are introduced, and their relevance for ophthalmology is discussed in detail. This paper represents an extensive study comparing the imaging quality of various IOLs including the comparison of measurements before and after injection through a cartridge as used for state-of-the-art implantation techniques. All measurements were performed using an MTF measurement system using a 546 nm optimized laser source and an effective aperture of 3.0 mm on the IOL according to ISO standard. An ISO standard eye model using an artificial cornea (spherical design) and a watery solution to simulate in vivo conditions was used.

Results: All IOLs apart from 1 +26 D lens complied with ISO standard requirements. However, the imaging quality varied up to 49% depending on the optical design and the manufacturing quality.

Conclusion: When the methods and materials recommended by the manufacturer for IOL injection through a cartridge were used, no long-term effect on the imaging quality of the IOLs was observed. However, the basic imaging quality of different designs and different manufacturers varied significantly (up to 50% at +26 D) IOLs and should be considered when choosing an IOL.