Energy distribution between distance and near images in apodized diffractive multifocal intraocular lenses.

PURPOSE To determine the energy distribution between the distance and near images formed in a model eye by spherical and aspheric apodized diffractive multifocal intraocular lenses (IOLs). METHODS The IOL was inserted in a model eye with an artificial cornea with positive spherical aberration (SA) similar to that of the human cornea. The energy of the distance and near images, as a function of the pupil size, was experimentally obtained by image analysis. The level of SA on the IOL, which is pupil-size-dependent, was determined from simulations. The influence of the SA was deduced from results obtained in monofocal IOLs and by comparison of the experimentally obtained energy efficiency to theoretical results based solely on the diffractive profile of the IOL. RESULTS In contrast with theoretical predictions, the energy efficiency of the distance image strongly decreased for large pupils, because of the high level of SA in the IOL. The decrease was smaller in the apodized diffractive multifocal lens with aspheric design. As for the near image, since the diffractive zone responsible for the formation of this image was the same in the spherical and aspheric lenses and the apertures involved were small (and so the level of SA), the results turned out to be similar for both designs. CONCLUSIONS For large pupils, the energy efficiency of the distance image is strongly affected by the level of SA, although aspheric IOLs perform slightly better than their counterparts with a spherical design. For small pupils, there are no differences between the spherical and aspheric IOLs.