PowerPoint-Pr

1
ga_at_uni-hd.de www.lasik-hd.de
Visualized light paths in different multifocal
intraocular lenses Auffarth GU, Rabsilber TM,
Mannsfeld A, Ehmer A, Limberger I.-J.
International Vision Correction Research Centre
(IVCRC), Dept. of Ophthalmology, University of
Heidelberg Acting Chairman G.U.Auffarth, MD
The authors have no financial interest in the
subject matter
2
Purpose - Introduction
Multifocal intraocular lenses (MIOL) developed
since the 1990s are rotationally symmetric and
are either based on the principles of diffraction
and/or refraction of the light or on a
combination of these two principles. 1-5 The
LENTIS Mplus multifocal intraocular lens
(Oculentis GmbH, Berlin, Germany) features a
completely new approach in multifocal lens
technology An aspheric, asymmetric
distance-vision zone is combined with a
sector-shaped near-vision zone of 3.0 diopters
allowing for seamless transition between the
zones. (Fig. 1, 2, 3)
Figure 1 Working principle Mplus technology
(Source Oculentis GmbH, Germany)
Figure 3 Embedded near segment in the lower IOL
part
Figure 2 Working principle Mplus technology
(Source Oculentis GmbH, Germany)
3
Methods - Optical Bench Laboratory Study
Multifocal intraocular lenses with different
optical principles were analysed including
refractive, diffractive, and a new near segment
design. Each IOL was placed in an eye model on an
optical bench including an optical lens that is
equal to the human cornea in terms of refractive
power and a surrounding solution which simulated
the vitreous body with regards to the refractive
index. A bundle of monochromatic green laser
light was projected through the eye model.
Pictures of the light paths were taken with a
digital camera.
Figure 4a Optical Bench Lab Setup, side view
MIOLs tested were The Rayner M-flex refractive
MIOL, the Oculentis M-Plus MIOL with segmental
zones, the AMO ReZoom refractive MIOL and the AMO
Tecnis diffractive MIOL
Figure 4b Optical Bench Lab Setup, front view
4
Results - Optical pathway on optical bench
Figure 5a Refractive MIOL I (ReZoom, AMO)
Figure 5b Refractive MIOL II (M-flex, Rayner)
Both refractive lenses (Fig. 5a, 5b) show diffuse
foci compared to the diffractive (fig 5c) or
segment (Fig. 5d) model with two defined foci for
near and distance vision.
Figure 5c Diffractive MIOL (ZM900, AMO)
Figure 5d Segmental MIOL (Mplus, Oculentis)
5
Results - Optical pathway on optical bench
Figure 6a Refractive MIOL I (ReZoom, AMO)
Figure 6b Refractive MIOL II (M-flex, Rayner)
The four pictures display the lens optical
images, rings or segment. Comparing the screen
images of the three multifocal concepts the Mplus
segment lens (Fig. 6d) shows less loss of light
than the refractive (Fig. 6a, 6b) or diffractive
(Fig. 6c) lenses.
Figure 6c Diffractive MIOL (ZM900, AMO)
Figure 6d Segmental MIOL (Mplus, Oculentis)
6
Conclusion
The optical bench analysis could demonstrate the
different foci for near and distance in all MIOL
types regardless the optical principle. The
refractive MIOLs and the diffractive IOLs showed
the already known pattern of light distribution.
The Oculentis Mplus MIOL showed a light
distribution similar to the refractive MIOLs but
with a distinct higher brightness indicating a
lower loss of contrast than the other MIOLs.
Figure 7 Retroilluminated photograph of a Mplus
IOL
References 1 Auffarth GU, Rabsilber TM, Kohnen
T, Holzer MP. Design and optical principles of
multifocal lenses. Ophthalmologe. 2008105522-6.
2 Auffarth GU, Dick HB. Multifocal intraocular
lenses. A review. Ophthalmologe. 200198127-37.
3 Buznego C, Trattler WB. Presbyopia-correcting
intraocular lenses. Curr Opin Ophthalmol. 2009
2013-8. 4 Pepose JS. Maximizing satisfaction
with presbyopia-correcting intraocular lenses
the missing links. Am J Ophthalmol.
2008146641-8. 5 Steinert RF. Visual outcomes
with multifocal intraocular lenses. Curr Opin
Ophthalmol. 20001112-21.