Subjective clinical visual disturbance scores correlation with simulated vehicle headlight halo in presbyopia-correcting intraocular lenses

To evaluate the correlation between objective bench assessment of halos and subjective clinical experience in patients receiving monofocal and presbyopia-correcting intraocular lenses (IOLs). Data from four clinical studies included patients with cataracts who received bilateral monofocal (SN60AT, SN60WF), extended depth-of-focus (EDOF; ZXR00, DFT015, 829MP), or multifocal (ZFR00V, TFNT00) IOLs. Subjective halo severity was assessed 6 months after implantation using the Questionnaire for Visual Disturbance (QUVID). Bench assessments were measured using a simulation of a 100-mm headlight at 31 m (20,000 cd/m2 intensity) and an IOL mounted in a model eye with a 4.5-mm pupil. The area under the curve (AUC) of intensity plot was calculated for each IOL and compared with the QUVID-based assessment using a statistical regression analysis. Correlation was assessed using linear regression analysis. In clinical studies, moderate to severe halos were reported by 29% to 48% of patients with diffractive (TFNT00, ZXR00, 829MP, ZFR00V), 11% with nondiffractive EDOF (DFT015), and 4% to 7% with monofocal (SN60WF and SN60AT) IOLs. Diffractive IOLs produced larger halos (AUC, 1448–1896) compared with nondiffractive EDOF (997) and monofocal (1002–1008) IOLs. Correlations were reported between bench halo AUC and patient-reported severity (no halo, r = − 0.92; little to mild halo, r = 0.43; moderate to severe halo, r = 0.93). A greater proportion of patients with diffractive versus nondiffractive IOLs reported severe halos. Bench halos correlated with subjective clinical experience, particularly for moderate and severe halos.