Optical and Visual Outcomes of a New Refractive Extended Depth of Focus Intraocular Lens

To characterize the optical design and analyze the optical quality and halo induced by the new extended depth of focus (EDOF) TECNIS PureSee intraocular lens (IOL) (Johnson & Johnson Surgical Vision) and to evaluate its clinical performance.

The power profile of the TECNIS PureSee was measured with the NIMO TR1504 device (LAMBDA-X). The through-focus modulation transfer function area (TF-MTFa) metric from +2.00 to -4.00 diopters (D) and the halo induced by the IOL in the best focus plane for distance vision (0.00 D), were assessed for 2-, 3-, and 4.5-mm aperture diameters at the IOL plane. The clinical evaluation in a cohort of patients included postoperative refraction, visual acuities, defocus curve, and subjective symptomatology.

The power profile shows distinct zones that meet relatively smoothly. The largest power change occurs in the central zone of the lens. The TF-MTFa curves showed an increase in depth of focus for smaller pupils. Larger pupils resulted in smaller, lower-intensity halos. For 2-, 3-, and 4.5-mm pupils, halo sizes were 18.64, 14.73, and 13.23 arcmin, respectively, and normalized energies were 0.55, 0.46, and 0.42, respectively. Clinical assessment yielded excellent visual and refractive outcomes, a depth of field from +1.00 to -2.00 D with visual acuities better than 0.2 logarithm of the minimum angle of resolution, and with almost no dysphotopic symptoms.

The TECNIS PureSee IOL provided good distance optical and visual quality and an extended depth of field of approximately 2.00 D. The depth of focus increased for smaller pupils. The halo induced by the lens was of low size and energy. [.