Visual performance of a new trifocal intraocular lens design evaluated with a clinical adaptative optics visual simulator.

Objective: The digital transformation of daily routines has increased visual demands, especially at intermediate and near distances. The Devil multifocal intraocular lens (MIOL) design was developed to enhance intermediate visual performance. This design is a novel trifocal intraocular lens inspired by the fractal structure known as the 'Devil's staircase'. The aim of this research is to evaluate the visual performance of the Devil MIOL design in real patients.

Methods: The visual acuity defocus curve was obtained from 25 eyes of healthy volunteers using the Visual Adaptive Optics Simulator (VAO, Voptica SL, Murcia, Spain). Additionally, images of optotypes simulating those seen through the Devil MIOL design were captured to qualitatively illustrate optotype perception at different vergence values.

Results: Mean visual acuity values of the evaluation were 0.03 logMAR at 0.00 D vergence, 0.10 logMAR at +1.50 D vergence, and 0.11 logMAR at +3.00 D vergence, corresponding to far (optical infinity), intermediate (66.7 cm), and near foci (33.3 cm), respectively. The experimental outcomes were indeed slightly better than numerical results obtained previously in a model eye.

Conclusions: The Devil MIOL design provides satisfactory visual acuity across three primary foci and produces extended depth of focus between the intermediate and near foci.