Optical and Clinical Outcomes of an Extended Range of Vision Intraocular Lens

Abstract

PURPOSE: To assess the in vitro optical quality and halo formation of the AcrySof IQ Vivity intraocular lens (IOL) (Alcon Laboratories, Inc) and to evaluate the clinical outcomes in patients who had bilateral implantation of this IOL. METHODS: The optical quality was evaluated with the PMTF optical bench (Lambda-X). Through-focus modulation transfer function area (MTFa) curves between −5.00 and +2.00 diopters (D) were obtained for 3- and 4.5-mm pupil apertures. The halo was assessed in vitro with a test bench. The clinical study included 30 patients. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and binocular defocus curve were evaluated 6 months postoperatively. RESULTS: The through-focus MTFa curve for the 4.5-mm pupil size showed only one peak at distance focus (38.4 units). For the 3-mm pupil size, the through-focus MTFa showed a lower peak of MTFa (28.9 units), located at −0.70 D, and an extended depth of focus up to −2.20 D. The halo formed was larger and more intense compared to a standard monofocal IOL. The clinical outcomes at 6 months revealed satisfactory visual acuity outcomes. All patients achieved a binocular CDVA of 0.1 logMAR or better. The mean visual acuity was better than 0.2 logMAR between +1.00 and −2.00 D of defocus. At a vergence of −2.50 D, the visual acuity was 0.31 ± 0.09 logMAR. CONCLUSIONS: The AcrySof IQ Vivity IOL provided good distance optical and visual quality and an extended range of focus of approximately 2.00 D, obtaining an optimal or functional visual acuity up to 50 to 40 cm. The halo formed was low intensity overall, but higher intensity than a monofocal IOL. [ J Refract Surg . 2022;38(3):168–176.]