Related Experiment Video
Updated: May 27, 2026
Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile
Published on: September 20, 2024
Modulation transfer function and optical quality after bilateral implantation of a +3.00 D versus a +4.00 D
Marcony R Santhiago1, Steven E Wilson, Marcelo V Netto
1Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44114, USA. marconysanthiago@hotmail.com
Purpose:
To determine whether the improvement in intermediate vision after bilateral implantation of an aspheric multifocal intraocular lens (IOL) with a +3.00 diopter (D) addition (add) occurs at the expense of optical quality compared with the previous model with a +4.00 D add.
Setting:
Department of Ophthalmology, University of São Paulo, São Paulo, Brazil.
Design:
Prospective randomized double-masked comparative clinical trial.
Methods:
One year after bilateral implantation of Acrysof Restor SN6AD1 +3.00 D IOLs or Acrysof Restor SN6AD3 +4.00 D IOLs, optical quality was evaluated by analyzing the in vivo modulation transfer function (MTF) and point-spread function (expressed as Strehl ratio). The Strehl ratio and MTF curve with a 4.0 pupil and a 6.0 mm pupil were measured by dynamic retinoscopy aberrometry. The uncorrected and corrected distance visual acuities at 4 m, uncorrected and distance-corrected near visual acuities at 40 cm, and uncorrected and distance-corrected intermediate visual acuities at 50 cm, 60 cm, and 70 cm were measured.
Results:
Both IOL groups comprised 40 eyes of 20 patients. One year postoperatively, there were no statistically significant between-group differences in the MTF or Strehl ratio with either pupil size. There were no statistically significant between-group differences in distance or near visual acuity. Intermediate visual acuity was significantly better in the +3.00 D IOL group.
Conclusion:
Results indicate that the improvement in intermediate vision in eyes with the aspheric multifocal + 3.00 D add IOL occurred without decreasing optical quality over that with the previous version IOL with a +4.00 D add.
