Perceptual cost and benefit of presbyopia-correcting intraocular lenses: effect of energy balance, addition, and adaptation.

Presbyopic intraocular lenses (IOLs) based on simultaneous vision represent a compromise between perceptual benefit and cost at near and far distances. We evaluated this compromise for simulated bifocal IOLs with varying energy distributions and additions using SimVis Gekko under different adaptation conditions. Presenting multifocal corrections after a blur adaptation with an abrupt transition of at least 5s improves acceptance. Smooth transitions to multifocality of at least 5s also improve acceptance, independently of previous adaptation. Corrections with low additions show more visual degradation at far without equivalent benefit at near. These results can be useful for IOL designers and clinicians to maximize multifocal adoption of IOLs.