Abstract

The appearance of images through a multifocal intraocular lens (IOL) was simulated. The optical transfer function (OTF) of a model eye containing the multifocal lens was measured and divided by the OTF of the model eye with a monofocal IOL. This ratio was used to filter digital images, generating simulations that represent the retinal images seen through a multifocal intraocular lens when viewed through an eye with a monofocal lens. A dichoptic side-by-side display was used to present the original image to one eye, implanted with the multifocal lens, while the other eye, implanted with monofocal lens, viewed the simulations and variations on the simulations to derive a point of subjective equivalence. Four subjects with such bilateral lens implants were tested for near and distance vision. The results validate the test methodology and the simulations. Referenced to the nominal theoretical filter, the prediction was within a 0.25-diopter (D) blur for distance simulation and within a 0.50-D blur for the near-vision simulation.

© 2001 Optical Society of America

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References

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  1. R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
    [CrossRef] [PubMed]
  2. J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
    [CrossRef] [PubMed]
  3. R. F. Steinert, “Visual outcomes with multifocal intraocular lenses,” Current Opinion in Ophthalmology 11, 12–41 (2000). Note: this review summarizes all recent publica-tions on the ARRAY multifocal IOL, the only FDA-approved product, and summarizes current publications of other multifocal and bifocal IOL designs available primarily in Europe.
    [CrossRef] [PubMed]
  4. A. P. Ginsburg, “Visual information processing based on spatial filters constrained by biological data,” Ph.D. dissertation (Cambridge University, Cambridge, UK, 1978).
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    [CrossRef] [PubMed]
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    [CrossRef] [PubMed]
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    [CrossRef]
  13. E. Peli, G. Geri, “Testing the simulation of peripheral vision with image discrimination,” in Vol. 30 of Digest of Technical Papers (Society for Information Display, Santa Ana, Calif., 1999), pp. 424–427.
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    [CrossRef] [PubMed]
  15. E. Peli, “Display nonlinearity in digital image processing for visual communications,” Opt. Eng. 31, 2374–2382 (1992).
    [CrossRef]
  16. D. Swift, S. Panish, B. Hippensteel, “The use of the Vision Works® in visual psychophysical research,” Spatial Vis. 10, 471–477 (1997).
    [CrossRef]
  17. A. Lang, V. Lakshminarayanan, V. Portney, “Phenomenological model for interpreting the clinical significance of the in vitro optical transfer function,” J. Opt. Soc. Am. A 10, 1600–1610 (1993).
    [CrossRef] [PubMed]

2000

R. F. Steinert, “Visual outcomes with multifocal intraocular lenses,” Current Opinion in Ophthalmology 11, 12–41 (2000). Note: this review summarizes all recent publica-tions on the ARRAY multifocal IOL, the only FDA-approved product, and summarizes current publications of other multifocal and bifocal IOL designs available primarily in Europe.
[CrossRef] [PubMed]

1999

R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
[CrossRef] [PubMed]

1997

J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
[CrossRef] [PubMed]

D. Swift, S. Panish, B. Hippensteel, “The use of the Vision Works® in visual psychophysical research,” Spatial Vis. 10, 471–477 (1997).
[CrossRef]

1996

1993

1992

V. Portney, “Optical testing and inspection methodology for modern intraocular lenses,” J. Cataract. Refract. Surg. 18, 607–613 (1992).
[CrossRef] [PubMed]

E. Peli, “Display nonlinearity in digital image processing for visual communications,” Opt. Eng. 31, 2374–2382 (1992).
[CrossRef]

1990

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

E. Peli, “Contrast in complex images,” J. Opt. Soc. Am. A 7, 2032–2040 (1990).
[CrossRef] [PubMed]

1981

B. L. Lundh, G. Derefeldt, S. Nyberg, G. Lennerstrand, “Picture simulation of contrast sensitivity in organic and functional amblyopia,” Acta Opthalmol. 59, 774–783 (1981).

Aker, B. L.

R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
[CrossRef] [PubMed]

Arend, L.

Artal, P.

Bradley, A.

L. N. Thibos, A. Bradley, “The limits of performance in central and peripheral vision,” in Vol. 22 of Digest of Technical Papers (Society for Information Display, Santa Ana, Calif., 1991), pp. 301–303.

Derefeldt, G.

B. L. Lundh, G. Derefeldt, S. Nyberg, G. Lennerstrand, “Picture simulation of contrast sensitivity in organic and functional amblyopia,” Acta Opthalmol. 59, 774–783 (1981).

Ferro, M.

Geri, G.

E. Peli, G. Geri, “Testing the simulation of peripheral vision with image discrimination,” in Vol. 30 of Digest of Technical Papers (Society for Information Display, Santa Ana, Calif., 1999), pp. 424–427.

Ginsburg, A. P.

A. P. Ginsburg, “Visual information processing based on spatial filters constrained by biological data,” Ph.D. dissertation (Cambridge University, Cambridge, UK, 1978).

Hippensteel, B.

D. Swift, S. Panish, B. Hippensteel, “The use of the Vision Works® in visual psychophysical research,” Spatial Vis. 10, 471–477 (1997).
[CrossRef]

Holladay, J. T.

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

Javitt, J. C.

J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
[CrossRef] [PubMed]

Labianca, A. T.

Lakshminarayanan, V.

Lang, A.

A. Lang, V. Lakshminarayanan, V. Portney, “Phenomenological model for interpreting the clinical significance of the in vitro optical transfer function,” J. Opt. Soc. Am. A 10, 1600–1610 (1993).
[CrossRef] [PubMed]

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

Larimer, J.

J. Larimer, “Designing tomorrow’s displays,” NASA Tech. Briefs 17, 14–16 (1993).

Lennerstrand, G.

B. L. Lundh, G. Derefeldt, S. Nyberg, G. Lennerstrand, “Picture simulation of contrast sensitivity in organic and functional amblyopia,” Acta Opthalmol. 59, 774–783 (1981).

Lubin, J.

J. Lubin, “A visual discrimination model for imaging system design and evaluation,” in Vision Models for Target Detection, E. Peli, ed. (World Scientific, Singapore, 1995), Chap. 10, pp. 245–283.

Lundh, B. L.

B. L. Lundh, G. Derefeldt, S. Nyberg, G. Lennerstrand, “Picture simulation of contrast sensitivity in organic and functional amblyopia,” Acta Opthalmol. 59, 774–783 (1981).

Miranda, I.

Navarro, R.

Nyberg, S.

B. L. Lundh, G. Derefeldt, S. Nyberg, G. Lennerstrand, “Picture simulation of contrast sensitivity in organic and functional amblyopia,” Acta Opthalmol. 59, 774–783 (1981).

Oksman, H. C.

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

Panish, S.

D. Swift, S. Panish, B. Hippensteel, “The use of the Vision Works® in visual psychophysical research,” Spatial Vis. 10, 471–477 (1997).
[CrossRef]

Peli, E.

E. Peli, L. Arend, A. T. Labianca, “Contrast perception across changes in luminance and spatial frequency,” J. Opt. Soc. Am. A 13, 1953–1959 (1996).
[CrossRef]

E. Peli, “Display nonlinearity in digital image processing for visual communications,” Opt. Eng. 31, 2374–2382 (1992).
[CrossRef]

E. Peli, “Contrast in complex images,” J. Opt. Soc. Am. A 7, 2032–2040 (1990).
[CrossRef] [PubMed]

E. Peli, G. Geri, “Testing the simulation of peripheral vision with image discrimination,” in Vol. 30 of Digest of Technical Papers (Society for Information Display, Santa Ana, Calif., 1999), pp. 424–427.

Portney, V.

A. Lang, V. Lakshminarayanan, V. Portney, “Phenomenological model for interpreting the clinical significance of the in vitro optical transfer function,” J. Opt. Soc. Am. A 10, 1600–1610 (1993).
[CrossRef] [PubMed]

V. Portney, “Optical testing and inspection methodology for modern intraocular lenses,” J. Cataract. Refract. Surg. 18, 607–613 (1992).
[CrossRef] [PubMed]

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

Rowe, M.

J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
[CrossRef] [PubMed]

Smith, P. J.

R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
[CrossRef] [PubMed]

Steinert, R. F.

R. F. Steinert, “Visual outcomes with multifocal intraocular lenses,” Current Opinion in Ophthalmology 11, 12–41 (2000). Note: this review summarizes all recent publica-tions on the ARRAY multifocal IOL, the only FDA-approved product, and summarizes current publications of other multifocal and bifocal IOL designs available primarily in Europe.
[CrossRef] [PubMed]

R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
[CrossRef] [PubMed]

Sun, R.

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

Swift, D.

D. Swift, S. Panish, B. Hippensteel, “The use of the Vision Works® in visual psychophysical research,” Spatial Vis. 10, 471–477 (1997).
[CrossRef]

Tarantino, N.

R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
[CrossRef] [PubMed]

J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
[CrossRef] [PubMed]

Thibos, L. N.

L. N. Thibos, A. Bradley, “The limits of performance in central and peripheral vision,” in Vol. 22 of Digest of Technical Papers (Society for Information Display, Santa Ana, Calif., 1991), pp. 301–303.

Trentacost, D. J.

R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
[CrossRef] [PubMed]

J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
[CrossRef] [PubMed]

van Dijk, H.

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

Wang, F.

J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
[CrossRef] [PubMed]

Willis, T. R.

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

Acta Opthalmol.

B. L. Lundh, G. Derefeldt, S. Nyberg, G. Lennerstrand, “Picture simulation of contrast sensitivity in organic and functional amblyopia,” Acta Opthalmol. 59, 774–783 (1981).

Appl. Opt.

Current Opinion in Ophthalmology

R. F. Steinert, “Visual outcomes with multifocal intraocular lenses,” Current Opinion in Ophthalmology 11, 12–41 (2000). Note: this review summarizes all recent publica-tions on the ARRAY multifocal IOL, the only FDA-approved product, and summarizes current publications of other multifocal and bifocal IOL designs available primarily in Europe.
[CrossRef] [PubMed]

J. Cataract Refract. Surg.

J. T. Holladay, H. van Dijk, A. Lang, V. Portney, T. R. Willis, R. Sun, H. C. Oksman, “Optical performance of multifocal intraocular lenses,” J. Cataract Refract. Surg. 16, 413–422 (1990); erratum, 781 (Nov.1990).
[CrossRef] [PubMed]

J. Cataract. Refract. Surg.

V. Portney, “Optical testing and inspection methodology for modern intraocular lenses,” J. Cataract. Refract. Surg. 18, 607–613 (1992).
[CrossRef] [PubMed]

J. Opt. Soc. Am. A

NASA Tech. Briefs

J. Larimer, “Designing tomorrow’s displays,” NASA Tech. Briefs 17, 14–16 (1993).

Ophthalmology

R. F. Steinert, B. L. Aker, D. J. Trentacost, P. J. Smith, N. Tarantino, “A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens,” Ophthalmology 106, 1243–1255 (1999).
[CrossRef] [PubMed]

J. C. Javitt, F. Wang, D. J. Trentacost, M. Rowe, N. Tarantino, “Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life,” Ophthalmology 104, 589–599 (1997).
[CrossRef] [PubMed]

Opt. Eng.

E. Peli, “Display nonlinearity in digital image processing for visual communications,” Opt. Eng. 31, 2374–2382 (1992).
[CrossRef]

Spatial Vis.

D. Swift, S. Panish, B. Hippensteel, “The use of the Vision Works® in visual psychophysical research,” Spatial Vis. 10, 471–477 (1997).
[CrossRef]

Other

E. Peli, G. Geri, “Testing the simulation of peripheral vision with image discrimination,” in Vol. 30 of Digest of Technical Papers (Society for Information Display, Santa Ana, Calif., 1999), pp. 424–427.

A. P. Ginsburg, “Visual information processing based on spatial filters constrained by biological data,” Ph.D. dissertation (Cambridge University, Cambridge, UK, 1978).

J. Lubin, “A visual discrimination model for imaging system design and evaluation,” in Vision Models for Target Detection, E. Peli, ed. (World Scientific, Singapore, 1995), Chap. 10, pp. 245–283.

L. N. Thibos, A. Bradley, “The limits of performance in central and peripheral vision,” in Vol. 22 of Digest of Technical Papers (Society for Information Display, Santa Ana, Calif., 1991), pp. 301–303.

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Figures (7)

Fig. 1
Fig. 1

Schematic illustration of the system used in the study. The original image was presented, through the LC shutters, only to the eye with the multifocal IOL (it could be presented on either the right or the left of the screen). The image presented to the eye with the monofocal IOL was filtered digitally. The filter was a ratio of the OTF’s of the schematic eye with the multifocal IOL to the OTF’s of the eye with a monofocal IOL. The various filters used are shown in Figs. 4 and 5. The monofocal eye was corrected with a lens for the screen distance. The multifocal IOL was either corrected for the screen distance (distance test) or presented with a total vergence of -2.75 D by using the combination of the distance and a negative lens. Assuming that the visual processing in each eye is equal implies apparent equality of perception when the digital filter correctly represents the ratio of the eyes’ OTF’s.

Fig. 2
Fig. 2

The measured MTF obtained for the schematic eye with a multifocal IOL (solid curves) and with a monofocal IOL (dashed curves). (a) The MTF’s with a multifocal lens for a distance (collimated) target (solid curve with dots), as well as additional MTF’s obtained at different levels of blur (solid curves). (b) The MTF’s with a multifocal IOL for a near (-2.75-D vergence) target (solid curve with dots) as well as additional MTF’s obtained at different levels of blur (solid curves). In both graphs the measured MTF’s obtained for the schematic eye with a monofocal IOL (dashed curves) are illustrated for a distance (collimated) target (dashed curve with circles) as well as additional MTF’s obtained at different levels of blur. The various blur levels MTF’s were used for the various filter designs illustrated in Figs. 4 and 5.

Fig. 3
Fig. 3

The four scenes used in the testing. The two images on top, Temple and Boats, were used for distance vision simulation and testing. The two images on the bottom, Holly and Chart, were used for near-vision testing at a nominal optical distance of 36 cm. Color images were used in the actual simulations and testing.  

Fig. 4
Fig. 4

The OTF ratios used to simulate the appearance of images from a near viewing distance. The predicted ratio (marked 0.0 D) was computed by dividing the OTF of the multifocal IOL, measured in a schematic eye from the near distance by the OTF of a best-corrected monofocal IOL. Blurrier images were obtained by measuring the OTF of the multifocal lens at different levels of blur (+0.25, +0.50, +0.75 D) while sharper images were obtained by blurring (-0.125, -0.25, -0.5 D) the monofocal IOL.

Fig. 5
Fig. 5

The OTF ratios (filters) used to simulate the appearance of images from a distance. The predicted ratio (marked 0.0 D) was computed by dividing the OTF of the multifocal IOL, measured in a schematic eye from a distance, by the OTF of a monofocal IOL in the same eye from the same distance. Blurrier images were obtained by measuring the OTF of the multifocal IOL at different levels of blur (+0.50, +0.75, +1.50 D), and sharper images were obtained by blurring (-0.125, -0.25, -0.5 D) the monofocal IOL.

Fig. 6
Fig. 6

Example of the data obtained for one subject (S4) at distance for the Boat image. Data points give the percent of the presentations in which the simulations were perceived blurrier than the image seen through the multifocal IOL. The fit represents a transition at 50% of -0.20 D as compared with a 0.0 D prediction. The image matching the original image seen through the multifocal IOL appeared slightly sharper than the 0.0 D prediction. The magnitude of the difference is very small; less than what would be caused by a 0.25-D error in the refraction. Note the point at 0.5 D that clearly deviates from the pattern of the rest of the data. This data point, the result of an erroneous filter, was not used in the fit.

Fig. 7
Fig. 7

Example of the data obtained for one subject (S3) at near distance for the Holly image. Data points give the percent of the presentations in which the simulations were perceived blurrier than the image seen through the multifocal IOL. The fit represents a transition at 50% of +0.5 D as compared with a 0.0 D prediction. The image matching the original image seen through the multifocal IOL is slightly blurrier than the 0.0 D prediction.

Tables (1)

Tables Icon

Table 1 50% Transition Point for Each Subject and Image as Derived from the Curve Fitting to the Data a

Equations (3)

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Ret(x¯)=C(F-1{OTF(k¯)F[object(x¯)]}),
Filteredimage(x¯)=F-1OTFmultifocaleyeOTFmonofocaleye F[object(x¯)].
P=norm[(d-D)/s],

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