Prediction of monocular defocus curves in pseudophakia with different pupil sizes

Existing models for predicting clinical visual acuity (VA) following lens replacement surgery use controlled experimental conditions where pupil size is typically fixed. However, pupil size may influence visual performance depending on the design of the intraocular lens (IOL) implanted. This study compares optical bench testing metrics to clinical VA in pseudophakic patients with different pupil sizes and IOL models. The area under the modulation transfer function (MTFa) and the weighted optical transfer function (wOTF) were obtained at vergences ranging from -3 D to 0.5 D, and different pupil sizes: 2, 3, and 4.5 mm. The simulated VA values obtained for both metrics were well correlated with clinical data (R² ≥ 0.85) and had low root mean square errors (RMSe) for the entire defocus range, suggesting their suitability for predicting VA defocus curves in pseudophakic eyes with varying pupil size.