{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:26:17Z","timestamp":1792805177059,"version":"4.5.0"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Carl Zeiss Meditec"},{"name":"Klaus Tschira Foundation","id":[{"id":"https:\/\/ror.org\/052jep661","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This laboratory study aims to assess the effects of misaligning different trifocal intraocular lenses (IOLs) under varying spectral and corneal spherical aberration (SA) conditions. Methods: With an IOL metrology device under monochromatic and polychromatic conditions, the following models were studied: AT ELANA 841P, AT LISA Tri 839MP, FineVision HP POD F, Acrysof IQ PanOptix, and Tecnis Synergy ZFR00V. The SA was simulated using an aberration-free and average-SA cornea. The modulation transfer function (MTF) was measured at different pupil sizes for the on- and off-axis lens positions. Results: The IOLs exhibited varying responses to decentration up to 1 mm, showing the lowest impact in polychromatic light. The least affected was AT ELANA, with an MTF loss of 15.7% to 28.4% at 50 lp\/mm across the studied conditions. It was followed by PanOptix and FineVision, with the MTF loss ranging from 19.1% to 36.0% and from 21.2% to 46.6%. AT LISA showed a more substantial reduction, i.e., 41.2% to 64.8%, but it was still lower than that of Synergy (51.1% to 78.8%). When decentration was induced at a 4.5 mm distance, its effect was more evident in conditions that were closer to each IOL\u2019s SA correction. A tilt of 5\u00b0 had a lesser impact than 1 mm decentration, with the effect being more severe at 4.5 mm. Conclusions: The off-axis position affects the optical quality of trifocal IOLs. Low- rather than high-SA-correcting trifocals perform better under misalignment. In polychromatic light, the impact of misalignment is less evident, suggesting a potential mitigating effect of chromatic aberration.<\/jats:p>","DOI":"10.3390\/jcm14010187","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T10:17:40Z","timestamp":1735640260000},"page":"187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A Comparative Analysis of the Effects of Misaligning Different Trifocal Intraocular Lenses"],"prefix":"10.3390","volume":"14","author":[{"given":"Weijia","family":"Yan","sequence":"first","affiliation":[{"name":"The David J Apple Center for Vision Research, Department of Ophthalmology, Heidelberg University Eye Clinic, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany"},{"name":"Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6927-5251","authenticated-orcid":false,"given":"Gerd U.","family":"Auffarth","sequence":"additional","affiliation":[{"name":"The David J Apple Center for Vision Research, Department of Ophthalmology, Heidelberg University Eye Clinic, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6237-7773","authenticated-orcid":false,"given":"Ramin","family":"Khoramnia","sequence":"additional","affiliation":[{"name":"The David J Apple Center for Vision Research, Department of Ophthalmology, Heidelberg University Eye Clinic, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"\u0141abuz","sequence":"additional","affiliation":[{"name":"The David J Apple Center for Vision Research, Department of Ophthalmology, Heidelberg University Eye Clinic, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.2147\/OPTH.S259011","article-title":"Presbyopia\u2014A Review of Current Treatment Options and Emerging Therapies","volume":"15","author":"Katz","year":"2021","journal-title":"Clin. 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