Abstract:  Objective  To evaluate the impact of tilt 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 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 tilt of 3°, 5°, 7°, 9°, and 11°. Main Outcome Measures MTF values, MTF curves, and USAF resolution test charts. Results With a tilt of 3°, the MTF values of all threeIOLs began to decline. And this decline continued at 5° and 7° tilt. The USAF images showed that all three IOLs maintained relatively good image quality within a tilt of 7°. With a tilt of 9°, the MTF values continued to decline, and the USAF image quality at intermediate focus of +30 D ZXR00 showed a significant decline. With a tilt of 11°, the 50 lp/mm MTF values for the +10 D, +20 D, and +30 D IOLs at the far focus were 0.336, 0.293, and 0.287, respectively, while at the intermediate focus, the values were 0.286, 0.271, and 0.210, respectively. Both the far and intermediate focus showed that the optical quality of the +10 D IOL was the best, while the +30 D IOL was the worst. At both far and intermediate focus, the MTF curves revealed that the lower the IOL diopter,the smaller decline in optical quality.After tilt, the MTF curves exhibited a greater decline in the high-frequency range and a smaller decline in the low-frequency range. Conclusion Tilt had a negative impact on the optical quality of the IOL. Within a tilt of 7°, the three diopter IOLs showed good resistance to tilt. Overall, the lower the IOL diopter, the better the tilt resistance. (Ophthalmol CHN, 2025, 34: 212-216)

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