Abstract: Objective To evaluate the impact of decentration on the optical quality of EDOF IOL with different diopters. Design Experimental study. Participants TECNIS Symfony ZXR00 EDOF IOL with different diopters. Methods OptiSpheric IOL R&D was used to evaluate the optical quality of the +10 D, +20 D, and +30 D ZXR00. Under the ISO-2 model cornea conditions, the defocus curves and defocus USAF images were obtained. The modulation transfer function (MTF) values at spatial frequencies of 50 lp/mm, MTF curves, and USAF resolution test charts were measured at each focal point of the IOL when the IOL was in the centered position and at decentration of 0.3, 0.5, 0.7, 0.9, and 1.1 mm. Main Outcome Measures MTF values, MTF curves, and USAF resolution test charts. Results The USAF resolution test charts demonstrated that the ZXR00 maintained good and stable image quality within a defocus range of 0 D to 2.00 D. At the centered position, the 50  lp/mm MTF values for the +10 D, +20 D, and +30 D ZXR00 at the far focus were 0.391, 0.410, and 0.456, respectively, while at the intermediate focus, the values were 0.321, 0.381, and 0.362, respectively. When decentered by 0.3 mm, the MTF values of three types of diopter IOLs began to decline. And this decline continued at 0.5 mm decentration. The USAF images showed that three types of diopter IOLs maintained relatively good image quality within a decentration of 0.5 mm. With a decentration of 0.7 mm, the MTF values for the +10 D, +20 D, and +30 D IOLs at the far focus were 0.228, 0.255, and 0.332, respectively, with the USAF images showing a significant decline in image quality. The MTF curves revealed that IOLs with higher diopters experienced a smaller decline in optical quality at the far focus, while IOLs with lower diopters showed a smaller decline at the intermediate focus. After decentration, the MTF curves exhibited a greater decline in the high-frequency range and a smaller decline in the low-frequency range. At the spatial frequency of 25 lp/mm, lower-diopter IOLs were less affected. Conclusion The EDOF IOL ZXR00 demonstrated consistent and stable image quality from far to intermediate distances. Decentration had a negative impact on the optical quality of the IOLs. Within a decentration of 0.5 mm, the three types of diopter IOLs showed good resistance to decentration. The degree of negative impact varied among different diopter IOLs, and the effects on the far and intermediate focus also differed. (Ophthalmol CHN, 2025, 34: 146-151)

Key words:  intraocular lens, extended depth-of-focus, in vitro test, decentration