Evaluating the impact of the water content of hydrophobic intraocular lenses on visual quality

The impact of the water content of hydrophobic intraocular lenses (IOLs) on visual quality remains unclear. This study investigated how the water content influenced photic phenomena. Optical bench studies were conducted to compare two hydrophobic trifocal IOLs: PanOptix® (low-water content IOL) and Clareon® PanOptix® (high-water content IOL). Modulation transfer function (MTF) measurements were used to evaluate optical quality, while point spread function (PSF) images were used to evaluate photic phenomena. To validate the optical bench results, a retrospective observational case series study was conducted using medical records for 85 eyes from 85 patients (PanOptix®, n = 38; Clareon® PanOptix®, n = 47). Postoperative visual outcomes were evaluated two months after the operation using a defocus curve for uncorrected visual acuity and contrast sensitivity (CS) with and without glare. Subjective satisfaction regarding spectacle independence and dysphotopsia was evaluated using a questionnaire. The optical bench study showed that the high-water content IOL exhibited a 6.16% smaller glare diameter in near-vision PSF analysis, and slightly higher MTF values at near distances. The clinical study supported these results, showing that the high-water content IOL provided better uncorrected visual acuity (P < 0.05) and spectacle independence (P = 0.016) at near distances. Additionally, the high-water content IOL showed higher contrast sensitivity with glare at 6.3° (P = 0.040) and 4° (P = 0.018). Hydrophobic IOLs with a higher water content improved contrast sensitivity and subjective satisfaction by reducing glistening and minimizing photic phenomena.