Abstract: PURPOSE: To evaluate the relationship between clinical, optical bench, and model-predicted through-focus performance of an extended depth-of-focus (EDOF) intraocular lens (IOL), and to determine how optotype choice influences clinically derived depth-of-focus measurements and their comparability across studies. MATERIALS AND METHODS: Thirty eyes implanted with the Aspicio™ monofocal IOL and 44 eyes implanted with the Asqelio™ nondiffractive EDOF IOL were evaluated 3 months postoperatively. Monocular clinical defocus curves were recorded under photopic conditions using best-distance correction, accounting for recognition versus resolution optotypes, using the Clinical Trial Suite system. Both lenses were also tested on an optical bench to obtain through-focus modulation transfer function (MTF) profiles and generate model-predicted defocus curves from bench data. RESULTS: The EDOF group demonstrated higher uncorrected and distance-corrected intermediate visual acuity, while corrected distance visual acuity remained comparable between groups. Optical bench testing showed a depth of focus of 0.5 D for the monofocal and 2.0 D for the EDOF IOL at the 0.1 MTF threshold. Clinically, the EDOF IOL demonstrated a broader and flatter through-focus response, maintaining ≤0.2 logMAR across ~1.75 D. Model-generated defocus curves closely matched clinical behavior and confirmed the efficacy underlying the extended range of vision. Applying optotype-based correction enabled a valid comparison of defocus performance between groups. CONCLUSIONS: Optical bench and computed defocus curves reliably predicted clinical through-focus performance, supporting their role as complementary tools in EDOF evaluation. Standardizing clinical methodology, including optotype selection or correction, may improve comparability across studies assessing IOL designs.
Hwang et al. (Fri,) studied this question.