PURPOSE: To investigate various methods for estimating visual acuity based on simulated Modulation Transfer Function (MTF) data in patients implanted with a monofocal intraocular lens (IOL).

METHODS: The clinical visual acuity from two distinct studies involving patients implanted with the enVista MX60E IOL was correlated with the normalized area under the curve (AUC) of the simulated MTF. Simulations were conducted using Zemax with a modified Liou-Brennan eye model using white light, incorporating a 20D IOL and a 3.0mm pupil. The AUC was normalized to the diffraction limit, with calculations performed across two frequency ranges: 0–50c/mm (AUC50) and 0–100c/mm (AUC100). Linear, logarithmic, exponential, logistic, and rational fitting models were applied to assess correlations.

RESULTS: In terms of R², the logistic, exponential, power law, and rational models yielded very similar results, all superior to the linear and logarithmic correlations. For these models, both AUC50 and AUC100 performed very similar while AUC50 showed slightly superior results for the linear and logarithmic correlations. Poorer visual acuities were more difficult to predict due to the higher standard deviations of the clinical studies.

CONCLUSION: Exponential correlation using the 0–100 c/mm frequency range appears to be the most cost-effective method for simulating expected visual acuity in patients implanted with IOLs.