In Vitro Evaluation of Multifocal Intraocular Lenses Based on the Point Spread Function: Optical Performance and Halo...

Background: Trifocal and extended depth-of-focus (EDoF) multifocal intraocular lenses (MIOLs) are currently widely used after cataract surgery to restore vision at multiple distances. In vitro studies of MIOLs are necessary to evaluate their optical behavior providing surgeons with evidence to support the appropriate selection of the best lens for each patient. Methods: The FineVision POD F, Acriva Trinova Pro C, AT LARA 829MP, and AcrySof IQ Vivity lenses were assessed using a dedicated optical bench. Optical quality was quantified using the through-focus modulation transfer function (TF-MTF) and the area under the modulation transfer function (MTFa), both calculated from the point spread function (PSF). Halo formation was qualitatively analyzed. Results: The FineVision POD F and Acriva Trinova Pro C lenses exhibited trifocal behavior, with optical performance varying according to pupil size and wavelength. The AT LARA 829MP lens functioned as a low-addition bifocal under monochromatic green light but demonstrated EDoF characteristics under polychromatic illumination. The AcrySof IQ Vivity lens displayed an EDoF profile derived from the superposition of multiple closely spaced foci under polychromatic evaluation. Halo assessment revealed lens-dependent differences, with the AcrySof IQ Vivity showing the smallest halo extent. Conclusions: This in vitro study demonstrates differences in the optical and chromatic performance of trifocal and EDoF IOLa. Trifocal designs showed variable behavior related to diffraction orders the use but generally favored far vision under mesopic conditions, with similar trends observed in EDoF lenses. EDoF designs produced fewer halos than trifocals. These quantitative findings may translate into clinically relevant effects, supporting MIOL selection tailored to patient needs and improving the predictability and personalization of surgical outcomes toward greater spectacle independence.