Clinical Outcomes of a New Non-Diffractive Extended Depth-of-Focus Intraocular Lens Targeted for Mini-Monovision

Nikola Tomagova, Sina Elahi, Kristof Vandekerckhove, Nikola Tomagova, Sina Elahi, Kristof Vandekerckhove

Abstract

Purpose: To assess visual acuity, binocular defocus curve, spectacle independence, and photic phenomena after bilateral same-day cataract surgery with implantation of an extended depth-of-focus intraocular lens (IOL) with mini-monovision.

Methods: Single-center retrospective study including 124 eyes from 62 patients who underwent bilateral implantation of an isofocal EDOF lens [Isopure® (BVI)] with mini-monovision (-0.50 D). Refraction, visual acuity at different distances, binocular defocus curves, spectacle independence, and subjective ratings of picture-referenced photic phenomena were assessed one to two months postoperatively.

Results: The mean postoperative refractive spherical equivalent was -0.15±0.41D in the dominant eyes and -0.46±0.35D in the mini-monovision eyes (p<0.01). Overall, 98.4% and 87.7% of the eyes were within ±1.00D and ±0.50D of the target refraction, respectively. Postoperative monocular corrected distance visual acuity was -0.04±0.07 logMAR. Binocular uncorrected visual acuity was -0.02±0.07, 0.13±0.11and 0.40±0.20 logMAR for far, intermediate and near, respectively. At the visual acuity threshold of 0.20 logMAR (or better) the defocus curve ranged from -1.6D to +0.9D. Reported spectacle-independence was 96% for far distance, 95% for intermediate, and 34% for near. Five percent of patients reported halos, 16% starburst, and 16% glare. Only 7% of all patients considered them bothersome.

Conclusion: In patients undergoing same-day bilateral cataract surgery, an isofocal EDOF lens provided an extended range of functional vision, up to 63 cm, resulting in useful uncorrected near vision, good uncorrected intermediate vision, and excellent uncorrected distance vision. Subjective patient satisfaction in terms of spectacle independence and photic phenomena was high.

Keywords: EDOF; Isopure; extended-depth-of-focus; mini-monovision; same-day bilateral cataract surgery.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2023 Tomagova et al.

Figures

Figure 1
Figure 1
Distribution of postoperative spherical equivalent in diopters for dominant and mini-monovision eyes. Note that the target refraction was emmetropia for the dominant eyes and −0.50 D for the mini-monovision eyes. The percentages of eyes within ±1.00 D and ±0.50 D of the target refraction are also shown.
Figure 2
Figure 2
(A) Cumulative binocular uncorrected visual acuity for distance (bin. UDVA), (B) intermediate (bin. UIVA), and (C) near (bin. UNVA). (D) Cumulative monocular uncorrected distance visual acuity (UDVA) for dominant and non-dominant eyes, and corrected distance visual acuity (CDVA) for all eyes. One to two months after surgery.
Figure 3
Figure 3
Mean ± standard deviation of monocular corrected distance visual acuity (CDVA),binocular uncorrected distance visual acuity (UDVA), binocular uncorrected intermediate visual acuity (UIVA), and binocular uncorrected near visual acuity (UNVA) one to two months after surgery.
Figure 4
Figure 4
Distance-corrected binocular defocus curve. The left y-axis shows logMAR visual acuity and the right y-axis the Snellen equivalent. Error bars represent standard deviation.
Figure 5
Figure 5
Percentage of patients reporting photic phenomena one to two months after surgery.

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