Visual acuity and image quality in 5 diffractive intraocular lenses



To compare objective image quality at distant, intermediate, and near foci with the corresponding visual acuity (VA) in patients symmetrically implanted with 5 different diffractive multifocal intraocular lenses (IOLs) (ReSTOR SV25T0, Tecnis ZKB00, Tecnis ZLB00, AT LISA 809, and AT LISA Tri 839MP) and a monofocal lens (Tecnis ZA9003) 3 months after cataract intervention.


Objective image quality, measured as the area under the modulation transfer function curve (AMTF), was tested in vitro in an eye model. In addition, corrected distance visual acuity and distance-corrected intermediate and near visual acuities (DCIVA and DCNVA) were assessed in a group of 79 patients, randomly implanted with one of the lenses.


Image quality and VA at the distant focus was good for all lens designs, but was similarly compromised at the intermediate focus, where the best DCIVA corresponded to the low add ZKB00. At the near focus, the monofocal lens and the distance dominant SV25T0 had the worst AMTF values, with the ZLB00 presenting the best DCNVA. The relationship between AMTF and VA was found not to be linear, with VA being similarly good for AMTF values over a certain threshold.


Visual acuity of pseudophakic patients reflected the optical quality of the specific IOL design within a certain range of measurements, beyond which maximum VA is limited by other ocular, optical, and neuropsychophysical factors.

Post author correction




Genís Cardona, Fidel Vega, Miguel A. Gil, Consuelo Varón, José A. Buil, María S. Millán

Article History


Financial support: Ministerio de Economia y Competitividad de Espa�a, project Ref. DPI2016-76019-R.
Conflict of interest: None of the authors has conflict of interest with this submission.

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  •  Applied Optics and Image Processing Group, Department of Optics and Optometry, Polytechnic University of Catalonia Barcelona Tech, Terrassa - Spain
  •  Ophthalmology Department, Santa Creu and Sant Pau Hospital, Autonomous University of Barcelona, Barcelona - Spain

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