Light-adjustable lens: customizing correction for multifocality and higher-order aberrations.

PURPOSE To determine the feasibility of creating customized multifocal and aspheric patterns onto a light-adjustable lens (LAL) using a digital light delivery (DLD) system. METHODS Silicone LALs were placed in a wet cell and irradiated in vitro using the DLD. Spatial intensity patterns were designed and generated to (1) create a multifocal optic with customized power and diameter and (2) simultaneously correct defocus and spherical aberration. In addition, the LALs were adjusted in vivo for defocus and spherical aberration using a rabbit model. Optical properties of the adjusted LALs were determined using a phase-shifting Fizeau Interferometer and a Shack-Hartmann wavefront sensor. RESULTS In vitro creation of multifocal patterns demonstrated ability to reproducibly customize zone diameter and power. Both bull's-eye bifocal and annular patterns were successfully created on LAL. Central adds ranging from +2.0 to +3.5 D with zone diameters ranging from 1.5 to 2.5 mm were demonstrated with the bull's-eye pattern. Application of the annular pattern showed that an annular zone ranging from +2.25 to +2.8 D was written around either an unchanged or -2.5 D corrected LAL central 2-mm region. Spherical aberration was reduced simultaneously with correction of hyperopia and myopia, both in vitro and in vivo. Additionally, these customized spatial intensity profiles can be written onto an LAL that is first adjusted to emmotropia. The ability to readjust the LAL is demonstrated. CONCLUSIONS Customized multifocal optics were created in vitro on the LAL. Spherical aberration was reduced simultaneously with correction of defocus both in vitro and in vivo. Potential correction for higher-order aberrations was also demonstrated.