Methods: An Adaptive Optics Visual Simulator (VAO, Voptica SL, Murcia, Spain) was used to measure visual acuity (VA) at far, intermediate (67 cm) and near (33 cm) distances in 6 eyes with paralyzed accommodation. A new aspheric IOL family with four models having different values of spherical aberration (ArtIOLs, Voptica SL, Murcia, Spain) were used. Inter-subject averages and 95% confidence intervals (CI), calculated as 1.96*SD, were estimated for all viewing distances.
Results: The mean values of VA at intermediate and near distances improved (from 0.12 to -0.06 at intermediate, from 0.57 to 0.11 LogMAR at near) as asphercity increased while VA at far decreased (from -0.12 to 0.10 LogMAR). However, visual performance for each lens design depended on each subject with an inter-subject variability of VA, expressed as CI, ranging between 0.05 and 0.2 LogMAR.
Conclusions: A new set of four aspheric IOLs have been designed to obtain different ranges of depth of focus. Each design can provide quite different visual performance for different subjects at different distances. Preoperative visual simulation using adaptive optics instruments, such as VAO, would allow selection of the optimum type IOL to customize vision.