Sensitivity Analysis of Toric and Multifocal IOL Optical Performance to Postoperative Tilt in the Presence of Corneal Aberrations

Abstract

Intraocular lenses (IOLs) are recognized as a solution in the treatment of eye conditions, particularly cataracts, by restoring vision through the replacement of the eye’s natural lens. Selecting the appropriate type of IOL, based on individual patient characteristics such as corneal aberrations, plays a crucial role in the visual outcomes after surgery. This study assessed the efficacy of innovative diffractive multifocal and toric IOLs in treating visual impairment associated with corneal aberrations using computational modeling. The study examined how aberrations affected the quality of retinal images as measured by the modulation transfer function (MTF), peak-to-valley wavefront error, and root mean square (RMS) wavefront error. The results showed that contrast and resolution in near, intermediate, and far vision were much enhanced by optimized IOL designs. Postoperative IOL tilt cannot be predicted preoperatively; therefore, this study is framed as a sensitivity analysis evaluating how varying degrees of tilt affect optical quality across different IOL designs. Our simulations also revealed that IOL tilt negatively correlated with visual acuity, especially toric IOLs showing greater sensitivity due to increased tilt-induced astigmatism. Since this approach is tailored to the individual characteristics, the results support the development of IOL designs with improved tolerance to tilt-induced aberrations.