Modulation Transfer Function of a Toric Intraocular Lens: Evaluation of the Changes Produced by Rotation and Tilt

PURPOSE: To evaluate the changes in optical quality when toric intraocular lenses (IOL) are rotated or tilted and to demonstrate that IOL rotation produces an increasing effect of aberrations. METHODS: Modulation transfer function (MTF) and average modulation were used to analyze the image quality of a toric IOL. The axis of the toric IOL was rotated 5°, 10°, 15°, 20°, 25°, and 30° in successive MTF measurements. The tilt values were 0° to 5°, in increments of 1°, plus a tilt of 15°. Pupil diameters of 3 and 5 mm were used. RESULTS: The MTF decay due to aberrations was more sensitive to rotation than tilt. The main decrement in the average modulation, of approximately 50% in both pupils, occurs when the IOL rotates from 0° to 5°. Between 0° and 1° tilt, the average modulation decreases approximately 25% for both pupils; with tilt >1°, the average modulation remains virtually unchanged. The points representing average modulation versus rotation angle are satisfactorily fitted by an exponential function, R=0.98. Average modulation versus tilt angle provides lower correlation degrees, R=0.91 and R=0.79, for 3- and 5-mm pupils, respectively. CONCLUSIONS: The MTF of the toric IOL decays with rotation and tilt, with greater decrement occurring in rotation from 0° to 5°. An asymptotic value exists in the average modulation decay, meaning that for angles higher than 15°, the average modulation of the toric IOL remains virtually constant.