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Purpose: To assess the power profile and optical performance of 2 extended range-of-vision (ERV) intraocular lenses (IOLs), TECNIS Eyhance (ICB00) and LuxSmart, and compare them with their monofocal counterpart lenses with similar platforms and materials: TECNIS 1-piece (ZCB00) and LuxGood, respectively., Setting: Optics and Optometry Faculties of Complutense University (Madrid) and Universitat Politècnica de Catalunya BarcelonaTech (Terrassa) in Spain., Design: Laboratory investigation on optical bench., Methods: For each design, the power distribution and (fourth and sixth-order) spherical aberration (SA) across the lens aperture were measured as well as the optical performance using modulation transfer function-based metrics with through-focus evaluation. 3 nominal powers (+10.00 diopters [D], +20.00 D, and +30.00 D) and 3 pupil sizes (2.0 mm, 3.0 mm, and 4.5 mm) were considered to assess whether the base power of the lens and pupillary dynamics have an influence on the depth-of-focus extension., Results: TECNIS Eyhance and LuxSmart IOLs had different power and SA profiles, but both designs shared a positive add power in their central region in comparison with their monofocal counterparts. LuxSmart had a greater add power while TECNIS Eyhance showed higher peak optical quality but smaller depth of focus., Conclusions: Differences of focus extension between the 2 ERV IOL designs are related to differences of power and SA profile. The nominal base power of the IOLs has little effect on their optical quality. However, pupil dynamics plays a key role since it determines the effective add power and optical performance of the ERV IOLs., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

The purpose was to review and document the methods used to calculate the power of the intraocular lens (IOL) to be implanted in cataract surgery in the specific scenario of eyes with keratoconus. This review included all scientific articles published in English that focused on the parameters and formulas used to calculate the power of the IOL to be implanted in eyes with keratoconus undergoing cataract surgery. There are few publications that show in detail how IOL power is calculated in these particular cases. If the keratometric value used was based on the standard refractive index (1.3375), it resulted in a postoperative refractive error with a tendency to hyperopia. The SRK/T formula yielded the best outcomes. The greater the severity of keratoconus the greater was the deviation of the postoperative refractive status from the target outcome.

Purpose: To evaluate changes in angle κ after the implantation of a trifocal intraocular lens (IOL) and to assess the postoperative outcomes of patients with different angle κ values., Setting: IOA Madrid Innova Ocular, Madrid, Spain., Design: Prospective trial., Methods: Sixty-three eyes from 63 patients who had bilateral implantation of a diffractive trifocal IOL (POD F, PhysIOL) were included. Pupil offset was used as the best estimate of angle κ and was measured using Pentacam (Oculus) preoperatively and at 3 months postoperatively. Postoperative refractive outcomes (sphere, cylinder, and manifest refraction spherical equivalent) and visual outcomes at far, intermediate, and near distance were assessed and compared between eyes with small pupil offset and eyes with large pupil offset. Quality of vision was assessed using a subjective questionnaire., Results: There was a significant decrease in pupil offset values postoperatively (mean: 0.197 ± 0.12 mm) compared with those preoperatively (mean: 0.239 ± 0.12 mm), with a mean decrease of -0.042 mm (P = .0002). The same significant decrease was found for both right and left eyes, when analyzed separately. No statistically significant difference was found in any of the refractive and visual acuity outcomes between eyes with small pupil offset and eyes with large pupil offset. The majority of patients (14 of 16) complaining of significant halos had eyes with small pupil offset., Conclusions: Large pupil offset did not negatively affect visual and refractive outcomes. The tolerance to larger pupil offset might be due to the IOL optical design, with the first diffractive ring being larger than other commonly used multifocal IOLs. More studies comparing various diffractive IOL models would be useful to confirm such hypothesis.

Purpose: To study the agreement between manifest refraction and objective refraction measured with two autorefractor models and an aberrometer in eyes implanted with a trifocal diffractive intraocular lens (IOL)., Setting: IOA Madrid Innova Ocular, Madrid, Spain., Design: Prospective comparative cohort study., Methods: An autorefractor keratometer (KR-8800), based on a Scheiner double pinhole, and a 3-dimension wavefront topography aberrometer system (OPD-Scan III), based on the scanning-slit retinoscopy principle, were used to obtain objective refraction readings. In addition, lower-order Zernike coefficients (Z) were used to calculate objective refraction. A set of 7 different results was obtained in power vector notation (spherical equivalent [SE], Jackson cross-cylinder, axes at 180 degrees and 90 degrees [J0] and Jackson cross-cylinder, axes at 45 degrees and 135 degrees [J45]) for 7 different methods: manifest refraction, autorefraction obtained with the autorefractor keratometer, WF-P (Z-based objective refraction for the photopic pupil), WF-M (Z-based objective refraction for the mesopic pupil), WF-4 (Z-based objective refraction for a 4.0 mm pupil), OPD-C (autorefraction measured with the 3-dimension wavefront topography aberrometer system under photopic conditions), and OPD-M (autorefraction measured with the 3-dimension wavefront topography aberrometer system under mesopic conditions)., Results: The study comprised 102 eyes from 51 cataract patients who underwent binocular implantation of a diffractive trifocal IOL (FineVision POD F). All 6 objective methods yielded more negative SE values than manifest refraction (P < .001). As for the astigmatism components (J0 and J45), only autorefraction (P = .003) and OPD-M (P < .001) differed significantly from manifest refraction. The best and worst correlation for the SE component were intraclass correlation coefficient (ICC) = 0.70 (for WF-M) and ICC = 0.48 (for WF-4)., Conclusion: Objective methods tend to yield more negative sphere values than manifest refraction., (Copyright © 2019 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)