Optical Performance Measurement and Night Driving Simulation of ReSTOR, ReZoom, and Tecnis Multifocal Intraocular Lenses in a Model Eye

PURPOSE: To measure the optical properties of multifocal intraocular lenses (IOLs) for different pupil sizes. METHODS: An artificial eye was fabricated that had both the average spherical aberration and chromatic aberration levels found in the human eye. This model eye contained a saline-filled wet cell into which various IOLs can be mounted. Pupil sizes of 3 and 6 mm were explored with the system. Using the model eye, the following IOLs were examined: Alcon ReSTOR apodized diffractive, AMO ReZoom zonal refractive, and Tecnis ZM900 full-aperture diffractive. The modulation transfer function (MTF) for the lenses was calculated. The model eye was also used as a portable device to photograph nighttime driving scenes. RESULTS: For 3-mm pupils, the apodized and full-aperture diffractive IOLs balance contrast between near and distance vision, whereas the zonal refractive IOL performs poorly for near vision. For 6-mm pupils, the apodized diffractive shifts performance from near vision to distance vision, whereas the zonal refractive and full-aperture diffractive IOLs continue to balance performance between distance and near. Subjectively, the night driving photographs showed much more stray light artifacts for the zonal refractive and the full-aperture and apodized diffractive IOLs. CONCLUSIONS: Under dark conditions, the shift of optical performance of the apodized diffractive lens towards distance vision reduces artifacts that appear under night driving conditions. These artifacts remain for the zonal refractive and full-aperture diffractive lenses.