Tilt and decentration tolerance of intraocular lenses: measurements with an improved mechanical model eye

Cataract, a clouding of the crystalline eye lens, is the leading cause of blindness. It can effectively be treated by cataract surgery, where the clouded lens is replaced by an artificial intraocular lens (IOL). Postoperative healing processes can cause a displacement of the IOL, which further leads to the fact that the quality of vision is deteriorated. Studies have shown that the imaging quality of high sophisticated IOL designs is more sensitive to lens displacements than simpler designs. The effects of IOL displacements are not well represented and tested within the current IOL test standard ISO 11979-2. This fact leads to the necessity to develope new test standards for novel and more sophisticated IOL designs. In this paper we present an improved model eye, which extends the current standard in three main aspects: First, the eye-model is very close to the physiology of the human eye. Second, electromechanic drives allow an automatic and precise simulation of postoperative lens tilts and decentrations, and finally in addition to standard conform MTF analysis, in the proposed setup also wavefront aberrations are measured. The latter reveals specific image aberrations caused by lens displacements. The model eye allows to objectively analyze the displacement tolerance of various IOL designs. The functionality of this novel setup is tested by measuring a spherical and an aspheric IOL design. Additionally, for comparison, IOLs that were already investigated with a previous version of the presented model eye are used for analysis. Measurements results reveal improvements compared to the previous version of the model eye and a functional prototype for wavefront measurement.