2984 – D0106

Binocular Vision with Rotationally Asymmetric Multifocal IOLs at Different Orientations

Tjundewo 1,2
Lawu , Kazuhiko 1
Ohnuma , Toru 3
Noda , and Pablo Artal 4
1Center
for Frontier Medical Engineering, Chiba University, Chiba, Japan; 2Research
and Development, HOYA Corporation Medical Division, Tokyo, Japan;
3Department of Ophthalmology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; 4Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain

Commercial Relationship Disclosure: None tjundewo.lawu@hoya.com

Purpose Results
This study investigates the possibility of improving visual All-Direction
Horizontal Optotypes Optotypes
outcomes using binocular combinations of a rotationally
asymmetric multifocal intraocular lens (IOL) with the
optimal orientation for each eye.

Methods
3-Dimensional display binocular visual simulator
An artificial eye model with a rotationally asymmetric
multifocal IOL was used to produce retinal images. We used
a 3-dimensional (3-D) display binocular visual simulator
(3DVS) to produce fixed orientation in one eye of a subject;
different orientations were used for the fellow eye.
Calculations were made for object distances at 0.0 to -3.0
diopters (D) in 0.25-D steps using the Landolt C optotypes
for a 3-mm pupil with induced spherical aberrations.
Retinal images with different orientations for left (OS) and right (OD)
eyes used for the 3DVS.
Binocular adaptive optics visual simulator
A binocular adaptive optics visual simulator (B-AOVS) was
used to measure the through-focus best-corrected visual
acuity (VAs) using a tumbling E from 0.0 to -2.5-D in 0.5-D
steps. The phase profile resembling an asymmetric IOL was
induced at 0 degrees in the OD eye and rotated in the OS
eye.
3DVS B-AOVS 3DVS
The binocular improvement relative to 0 degrees
monocularly was calculated as − (average binocular −
average monocular) logMAR VA for all object distances.
Using optotypes with a horizontal gap (horizontal
orientation for both the Landolt C and tumbling E), we
found similar results with both the 3DVS and B-AOVS
methods, i.e., significant binocular improvements with less
improvement for the orthogonal combination. However,
Experimental procedure
interestingly, better improvement was achieved with the
The monocular and binocular logarithm of the minimum orthogonal combination with all gap optotype orientations.
angle of resolution (logMAR) VAs were examined as a
function of object distances in 9 subjects with the 3DVS and
2 subjects with the B-AOVS. The average binocular VAs for
Conclusions
all object distances were compared to the monocular VAs. The binocular VA with a rotationally asymmetric multifocal
IOL design improved by about one half line of vision.
0° 45° 90° 135° 180° 225° 270° 315° Interestingly, the VA with the orthogonal orientation
binocularly was better compared to the other orientations.
OS
These findings suggested that using the orthogonal
orientation of the rotationally asymmetric multifocal IOL
OD design may be another binocular approach to optimize
visual outcomes.