Comparative in vivo modulation transfer function (MTF) in refractive multifocal and monofocal IOLs using a pyramidal sensor aberrometer

Abstract A prospective, consecutive, comparative, case series study was conducted to study and compare in vivo the retinal image quality following implantation with different multifocal refractive IOLs by analyzing the point spread function (PSF) Strehl ratio and the modulation transfer function (MTF) using a pyramidal wavefront sensor (PWS)-based aberrometer. This study included 90 eyes of 70 patients implanted with: (a) 19 AcrySof SA60AT (control group); (b) 24 LENTIS LS-313 MF30; c) 33 LENTIS LS-313 MF15; (d) 20 Precizon Presbyopic. Main outcome measures were MTFa, PSF Strehl ratio, PSF Strehl ratio excluding second-order aberrations (PSFw2), total root mean square, low-order aberration and high-order aberration. SA60AT (group A) showed the highest values of MTFa at 3.0, 4.0 and 5.0 mm pupil sizes (17.53 ± 4.72,15.82 ± 4.19 and 15.39 ± 3.23), followed by Oculentis MF15 (14.57 ± 4.22, 12.57 ± 3.12, 10.1 ± 2.54). There were not significant differences at 2.0 mm pupil size among groups. MTFa significantly changed with pupil diameter in groups B, C and D; however, SA60AT MTFa value wasn’t affected by pupil size. The analysis of PSF and MTFa using a PWS-based aberrometer may guide physicians in IOL selection.