Visual Performance and Optical Quality After Implantation of Non-diffractive Enhanced Depth of Focus Intraocular Lenses.

Abstract

Purpose: To evaluate visual and refractive outcomes, visual quality, patient satisfaction, and spectacle independence 3 months after phacoemulsification with bilateral non-diffractive enhanced depth of focus (EDOF) lens implantation.

Methods: This study included 68 eyes of 34 consecutive patients, with 51.5% undergoing refractive lens exchange and 48.5% undergoing cataract surgery. Exclusion criteria included previous ocular surgery, corneal higher order aberrations greater than 0.6 μm, and corneal astigmatism greater than 1.50 diopters (D). Mini-monovision of -0.50 D was targeted. Uncorrected and corrected distance visual acuity was measured at 4 m and 66 and 40 cm. Patient satisfaction was assessed using subjective questionnaires. Modulation transfer function, Strehl ratio, and objective depth of focus were measured with ray-tracing.

Results: At 3 months, the follow-up rate was 97.1% and mean corrected distance visual acuity at 4 m and 66 and 40 cm was -0.02 ± 0.10, 0.11 ± 0.11, and 0.36 ± 0.13 logarithm of the minimum angle of resolution (logMAR), respectively. Monocular defocus curve was higher than 0.20 logMAR from +1.50 to -1.50 D. Mean Objective Scatter Index score at 3 months was 1.48 ± 0.72; it decreased significantly in eyes with cataract and increased significantly in eyes that had refractive lens exchange (P < .05). Spectacle independence was achieved by 95%, 100%, and 34% patients for far, intermediate, and near distances, respectively; 90% patients reported no photic phenomena. Patients were satisfied with daily life activities not requiring near vision.

Conclusions: Bilateral implantation of a non-diffractive EDOF lens resulted in good visual performance at far and intermediate distances, with functional near vision at 3 months postoperatively. Patient satisfaction and spectacle independence were high.