Quantification of Peripheral Blur in Ultra-Widefield Fundus Imaging Following Diffractive Multifocal Intraocular Lens...

Area of Science:

• Ophthalmology and Optometry
• Optical Engineering
• Medical Imaging

Background:

• Cataract surgery commonly involves intraocular lens (IOL) implantation.
• Diffractive multifocal IOLs offer enhanced vision but their effect on peripheral retinal imaging is unknown.
• Ultra-widefield (UWF) fundus imaging captures peripheral retinal details crucial for diagnosis.

Purpose of the Study:

• To objectively quantify peripheral image sharpness in UWF fundus photographs.
• To compare image quality between diffractive multifocal IOLs and enhanced monofocal IOLs.
• To assess wavelength-specific differences in peripheral image sharpness.

Main Methods:

• Retrospective cohort study analyzing 65 eyes with enhanced monofocal or diffractive multifocal IOLs.
• Acquisition of non-mydriatic UWF fundus photographs (~200°) within one month post-surgery.
• Analysis of red, green, and composite channels using sharpness metrics (Laplacian, Brenner, Tenengrad) in a peripheral annular region.

Main Results:

• Significantly lower peripheral sharpness in the red channel for multifocal IOLs (Brenner and Tenengrad metrics, p < 0.05).
• No significant differences in green or composite channels, or by Laplacian metric.
• Heatmaps showed reduced gradient magnitude in the peripheral annular zone for multifocal IOLs.

Conclusions:

• Diffractive multifocal IOLs are associated with reduced peripheral red channel sharpness, possibly due to transverse chromatic aberration.
• Overall composite channel image quality is comparable between multifocal and monofocal IOLs.
• Findings may guide IOL selection and interpretation of peripheral retinal images in patients with multifocal IOLs.