A theoretical study of intraocular lens tilt and decentration on perceptual image quality

Maps of perceptual image quality were generated for a range of intraocular (IOL) tilts and decentrations, using a perceptually based metric i.e. the square integral (SQRI) metric. Maps were generated for a well-corrected eye, and for hyperopic (-0.1 mm) and myopic (+0.1 mm) image planes (for 2 and 4 mm pupils). These perceptually based results were compared with a standard optical measure (i.e. the equivalent SQRI for given spectacle power added at the cornea). The image quality changes in maps were small, but detectable (exceeding the perceptual just noticeable difference (jnd) or 1 jnd threshold). Clockwise (negative) tilt combined with decenter fell below the 'contrast reserve' modulation transfer functions (MTFs) for 0.25 and 0.5 D defocus, 4 mm pupil. These errors were larger than those found previously, probably because of the shape-factor of the IOL used. Pupil size contributed the largest drop in SQRI value, followed by clockwise tilt combined with decenter. Anticlockwise tilt with decenter produced image quality improvements for the hyperopic eye. Spot diagrams confirmed defocus and the balance of coma-like aberration and astigmatism as causes of the changes in SQRI values. The SQRI maps conveniently summarize imaging, and may be a useful tool in assessing image quality in eye modelling applications.