The first group is conventional spherical IOLs, which feature a spherical optical surface and therefore induce a positive amount of SA by design. There are mainly three different IOL concepts on the market based on SA. The amount of SA is of particular interest, as it interacts with the SA of the patient’s cornea and thus determines the achievable optical resolution and depth of focus. The current monofocal lenses comprise a variety of different optical concepts, which can be characterized by the optical design, that determines for example the amount of Spherical Aberration (SA) that is being induced by the optic, the spectral filtering properties, the chromatic dispersion of the material, and, of course, the geometrical design (e.g., sharp optic edge, haptic design, and angulation). The standard of care in cataract surgery is monofocal intraocular lenses (IOLs). The other enhanced monofocal IOL, ICB00, provided a sustained improvement in simulated intermediate VA and maintained distance image quality comparable to that of the standard aspheric monofocal IOLs, even for larger pupils. Optical bench results showed that the ISOPure and RayOne-EMV provide similar performance to a spherical monofocal IOL, with a strong pupil dependency for distance and intermediate vision. ICB00 provided the same distance sVA as the aspheric monofocal IOLs and the lowest variability in MTF with pupil size. Similar to the spherical monofocal IOL, the ISOPure and RayOne-EMV showed a strong correlation between improvement in intermediate sVA and reduction of distance sVA and MTF, and increasing pupil size. For ICB00, the improvement was independent of the pupil size, while for the ISOPure and RayOne-EMV, the intermediate sVA improved with increased pupil size. The enhanced monofocal IOLs provided an improvement in the intermediate sVA as compared to standard monofocal IOLs. Three enhanced monofocal IOLs (ICB00, ISOPure, and RayOne-EMV) and three standard monofocal IOLs: two aspheric (ZCB00 and SN60WF) and one spherical (AAB00) were included. Through-focus Visual Acuity (VA) was simulated from these measurements (sVA). Distance image quality was evaluated using Modulation Transfer Function (MTF) measurements. Optical bench testing in white light was performed for different pupils, using an average cornea eye. The purpose of this study is to evaluate the effect of pupil size on the through-focus optical performance of three new enhanced monofocal IOLs, designed to improve the range of vision as compared to standard monofocal IOLs. A new generation of enhanced monofocal IOLs has been introduced to slightly increase the depth of focus as compared to standard monofocal IOLs.
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