A Blended Approach to Spectacle Independence After Cataract Surgery Using a Novel Extended Depth of Focus Intraocular Lens.

Abstract

Purpose: To evaluate the effectiveness of a blended approach to spectacle independence after cataract surgery using a novel extended depth of focus (EDOF) lens.

Methods: This retrospective comparative study took place at Mosman Eye Centre, Australia. This was a single-site, single-surgeon study evaluating patients who underwent consecutive bilateral cataract surgery with implantation of a novel EDOF lens using a symmetrical (both eyes +1.50 diopter [D] add) or blended (dominant eye +1.50 D, non-dominant +3.00 D) approach. Endpoints included uncorrected (UDVA) and corrected (CDVA) distance visual acuity and intermediate (45 and 60 cm) and near (30 cm) visual acuity at 1 month. Additional endpoints included postoperative refraction, spectacle independence, overall satisfaction with vision, and adverse events.

Results: Overall, 148 eyes of 74 patients were included, 41 patients in the symmetrical group and 33 in the blended group. The mean age was 72.28 ± 8.18 years (range: 50 to 89 years) with 33.78% being men. Both near and distance visual acuity improved significantly for both refractive approaches (P < .001). All eyes (148/148) were within 0.18 D of emmetropia postoperatively. Comparing the two approaches, postoperative distance, intermediate, and near UDVA was significantly better for the blended approach: -0.09 ± 0.05 versus -0.03 ± 0.07 at 6 m (P = .03), 7.97 ± 2.98 N versus 9.12 ± 2.63N at 30 cm (P = .014), .47 ± 2.21 N versus 8.68 ± 2.17 N at 45 cm (P = .001) and 8.32 ± 2.48 N versus 9.12 ± 2.00 N at 60 cm (P = .03). Postoperative adverse events were comparable between the groups and similar to previous reports.

Conclusions: Blended EDOF IOL implantation using +1.50 and +3.00 D addition resulted in excellent distance, intermediate, and near vision, with a high rate of spectacle independence and low rate of reported visual disturbances. Future randomized comparative trials with a larger sample size, longer follow-up, and additional objective assessments of postoperative visual quality, such as contrast sensitivity, are needed to further validate these findings.