Impact of pupil size and corneal spherical aberrations on the performance of monofocal intraocular lenses: an experimental model

In this study, an in vitro comparison of the optical performances of three models (spherical, aberration-neutral, and aberration-correcting) of monofocal intraocular lenses (IOLs) is proposed. A comprehensive model is employed, encompassing a wide range of corneal models and aperture sizes, reflecting the high variability of corneal spherical aberrations (SA) and pupil sizes in both normal and postoperative refractive corneal surgery populations. Analysis of average through-focus modulation transfer function (MTF) curves reveals significant differences in optical performance attributable to pupil size and corneal SA. These differences depend on the IOL model and affects MTFmax (representing contrast at best focus), depth of focus, refractive error tolerance, and the effective power of the lens.