Patient-Perceived and Laboratory-Measured Halos Associated with Diffractive Bifocal and Trifocal Intraocular Lenses

ABSTRACT

Purpose: To examine and assess the halos generated in distance vision by multifocal intraocular lenses (IOLs) using both in vitro objective and in vivo subjective methods.

Setting: The objective method was carried out in the optics laboratory of the Applied Optics and Image Processing Group (Universitat Politècnica de Catalunya -Barcelona). The psychophysical and subjective methods were carried out in the Instituto de Oftalmología Avanzada Madrid Innova Ocular.

Design: Optical bench results and prospective evaluation of consecutive cases.

Methods: The IOLs examined were TECNIS^®one-piece bifocals with addition powers of +4.00 D, +3.25 D, and +2.75 D and the trifocals AT-LISA-tri^® and FineVision^®. In the objective assessment, we examined halos around the far focus images of a pinhole formed by each IOL in an optical bench. For the in vivo study, we recruited 100 patients who had been bilaterally implanted one month earlier with the IOLs under study. Participants were subjected to psychophysical halometry (Halo v1.0) on the eye with better, distance-corrected, visual acuity and were required to subjectively grade halos by responding to the question “How much do halos bother you?”

Results: The objective method revealed that the halo size increased with addition power and that the two trifocals gave rise to a double-halo pattern. Scores in the halometry also indicated a direct relationship between the halo size and addition power. The subjective results indicated fewer complaints about halos associated with the trifocal than bifocal IOLs.

Conclusions: The addition power of the tested IOLs affected both laboratory-measured and patient-perceived halos. Trifocal lenses generated fewer complaints about halos.

Precise: Multifocal intraocular lenses (MIOLs) give rise to halos observed by patients under conditions of dim lighting. This study compares laboratory characterized halos generated by five MIOLs with patient-perceived halos.

KEYWORDS:

• Cataract
• presbyopia
• multifocal IOLs
• halo

Acknowledgments

Some of the data reported here were presented as a poster at the XXXIII ESCRS Meeting held in Barcelona in September 2015 (awarded first prize).

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

At the point of the submission of this paper, Francisco Alba-Bueno was an employee of the department of Medical & Regulatory Affairs of Alcon-Novartis. During the research and writing period of this paper he used to work for Valles Ophthalmology Research (VOR) – Institute of Medical and Surgical Ophthalmology (OMIQ).

Funding

This work was supported by project DPI2016-76019-R from the Spanish Ministerio de Economía y Competitividad and Fondos FEDER.

Additional information

Funding

This work was supported by project DPI2016-76019-R from the Spanish Ministerio de Economía y Competitividad and Fondos FEDER.