Extended Depth-of-Field Intraocular Lenses: An Update

Piotr Kanclerz, Francesca Toto, Andrzej Grzybowski, Jorge L Alio, Piotr Kanclerz, Francesca Toto, Andrzej Grzybowski, Jorge L Alio

Abstract

Extended depth-of-focus (EDOF) is a new intraocular lens (IOL) technology in the treatment of presbyopia. In contrast to multifocal (MF) IOLs, EDOF lenses create a single elongated focal point, rather than several foci, to enhance depth of focus. In this way, EDOF IOLs aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage is a decrease of retinal image quality if the amount of the aberrations is excessively increased. Frequently, EDOF IOLs are combined with MF optical designs; for this reason, EDOF IOLs are commonly a subject of confusion with optical multifocality concepts. The aim of this article is to clarify what an EDOF IOL is and to discuss the recently reported outcomes with these IOLs. We propose naming lenses that have combined optical designs as "hybrid IOLs."

Conflict of interest statement

There authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Spherical (A) vs chromatic (B) aberrations.
FIGURE 2
FIGURE 2
Spherical aberration-based EDOF IOLs: (A) Sifi Mini Well Ready, (B) medicem wichterle intraocular lens-continuous focus, (C) Tecnis Eyhance ICB00. EDOF IOLs indicates extended depth-of-focus intraocular lenses.
FIGURE 3
FIGURE 3
EDOF IOLs utilizing the pinhole effect. (A) Acufocus IC-8, (B) XtraFocus Pinhole Implant. EDOF IOLs indicates extended depth-of-focus intraocular lenses.
FIGURE 4
FIGURE 4
Hybrid MF Diffractive/EDOF IOLs: Tecnis Symfony. EDOF IOLs indicates extended depth-of-focus intraocular lenses; MF, multifocal.
FIGURE 5
FIGURE 5
Hybrid MF refractive/EDOF IOLs: (A) Lentis Mplus X, (B) Acunex Vario AN6 V, (C) Swiss Advanced Vision Lucidis. EDOF IOLs indicates extended depth-of-focus intraocular lenses; MF, multifocal.
FIGURE 6
FIGURE 6
Hybrid MF Refractive-Diffractive/EDOF IOLs: (A) Swiss Advanced Vision Eden, (B) Swiss Advanced Vision Harmonis, (C) Tecnis Synergy: ZFR00. EDOF IOLs indicates extended depth-of-focus intraocular lenses; MF, multifocal.

References

    1. Grzybowski A, Kanclerz P. Recent developments in cataract surgery. In: Grzybowski A, editor. Current Concepts in Ophthalmology. Vol 124. Cham: Springer International Publishing; 2020:55–97.
    1. Alió JL, Pikkel J, eds. Multifocal Intraocular Lenses: The Art and the Practice. Cham, Switzerland: Springer International Publishing; 2019.
    1. Alio JL, Plaza-Puche AB, Férnandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: an overview. Surv Ophthalmol 2017; 62:611–634.
    1. Savini G, Balducci N, Carbonara C, et al. Functional assessment of a new extended depth-of-focus intraocular lens. Eye (Lond) 2019; 33:404–410.
    1. Savini G, Schiano-Lomoriello D, Balducci N, Barboni P. Visual performance of a new extended depth-of-focus intraocular lens compared to a distance-dominant diffractive multifocal intraocular lens. J Refract Surg 2018; 34:228–235.
    1. Alió JL, Grzybowski A, Kanclerz P. Extended Depth-of-Field Intraocular Lenses. In: Alió JL, Pikkel J, eds. Multifocal Intraocular Lenses: The Art and the Practice, 2nd Ed. Essentials In Ophthalmology. Cham, Switzerland: Springer International Publishing; 2019:335-344.
    1. Gallego AA, Bará S, Jaroszewicz Z, Kolodziejczyk A. Visual Strehl performance of IOL designs with extended depth of focus. Optom Vis Sci 2012; 89:1702–1707.
    1. Domínguez-Vicent A, Esteve-Taboada JJ, Del Águila-Carrasco AJ, Monsálvez-Romin D, Montés-Micó R. In vitro optical quality comparison of 2 trifocal intraocular lenses and 1 progressive multifocal intraocular lens. J Cataract Refract Surg 2016; 42:138–147.
    1. Domínguez-Vicent A, Esteve-Taboada JJ, Del Águila-Carrasco AJ, Ferrer-Blasco T, Montés-Micó R. In vitro optical quality comparison between the Mini WELL Ready progressive multifocal and the TECNIS Symfony. Graefes Arch Clin Exp Ophthalmol 2016; 254:1387–1397.
    1. Alio JL. Presbyopic lenses: evidence, masquerade news, and fake news. Asia Pac J Ophthalmol (Phila) 2019; 8:273–274.
    1. Böhm M, Petermann K, Hemkeppler E, Kohnen T. Defocus curves of 4 presbyopia-correcting IOL designs: diffractive panfocal, diffractive trifocal, segmental refractive, and extended-depth-of-focus. J Cataract Refract Surg 2019; 45:1625–1636.
    1. Nakazawa M, Ohtsuki K. Apparent accommodation in pseudophakic eyes after implantation of posterior chamber intraocular lenses: optical analysis. Invest Ophthalmol Vis Sci 1984; 25:1458–1460.
    1. Rocha KM. Extended depth of focus IOLs: the next chapter in refractive technology? J Refract Surg 2017; 33:146–149.
    1. Lai YJ, Yeh SI, Cheng HC. Distribution of corneal and ocular spherical aberrations in eyes with cataract in the Taiwanese population. Taiwan J Ophthalmol 2015; 5:72–75.
    1. Cheng H, Barnett JK, Vilupuru AS, et al. A population study on changes in wave aberrations with accommodation. J Vis 2004; 4:272–280.
    1. Artal P, Manzanera S, Piers P, Weeber H. Visual effect of the combined correction of spherical and longitudinal chromatic aberrations. Opt Express 2010; 18:1637–1648.
    1. Breyer DRH, Kaymak H, Ax T, Kretz FTA, Auffarth GU, Hagen PR. Multifocal intraocular lenses and extended depth of focus intraocular lenses. Asia Pac J Ophthalmol (Phila) 2017; 6:339–349.
    1. Campbell FW. The depth of field of the human eye. Optica Acta 1957; 4:157–164.
    1. Narang P, Agarwal A, Ashok Kumar D, Agarwal A. Pinhole pupilloplasty: Small-aperture optics for higher-order corneal aberrations. J Cataract Refract Surg 2019; 45:539–543.
    1. Stiles WS, Crawford BH. Luminous efficiency of rays entering the eye pupil at different points. Nature 1937; 139:246–1246.
    1. SIFI Medtech supplement - Mini Well - EuroTimes. EuroTimes. Available at: . Published November 2, 2016. Accessed February 4, 2020.
    1. Giers BC, Khoramnia R, Varadi D, et al. Functional results and photic phenomena with new extended-depth-of-focus intraocular Lens. BMC Ophthalmol 2019; 19:197.
    1. WIOL-CF Cilnical Results. Available at: . Accessed February 5, 2020.
    1. Kim YC, Kang KT, Yeo Y, Kim KS, Siringo FS. Consistent pattern in positional instability of polyfocal full-optics accommodative IOL. Int Ophthalmol 2017; 37:1299–1304.
    1. Lee YH, Kim YC. In-the-bag dislocation of polyfocal full-optics accommodative intraocular lens: a case report. Indian J Ophthalmol 2019; 67:1200–1202.
    1. Kang KT, Kim YC. Dislocation of polyfocal full-optics accommodative intraocular lens after neodymium-doped yttrium aluminum garnet capsulotomy in vitrectomized eye. Indian J Ophthalmol 2013; 61:678–680.
    1. Studeny P, Krizova D, Urminsky J. Clinical experience with the WIOL-CF accommodative bioanalogic intraocular lens: Czech national observational registry. Eur J Ophthalmol 2016; 26:230–235.
    1. Siatiri H, Mohammadpour M, Gholami A, Ashrafi E, Siatiri N, Mirshahi R. Optical aberrations, accommodation, and visual acuity with a bioanalogic continuous focus intraocular lens after cataract surgery. J Curr Ophthalmol 2017; 29:274–281.
    1. J & J Vision. Delivering Intermediate Vision: The New TECNIS Eyhance Monofocal IOL. The Ophthalmologist. Available at: . Published April 3, 2019. Accessed February 5, 2020.
    1. Discover the IC-8 Lens - IC-8 Lens. IC-8 Lens. Available at: . Accessed February 5, 2020.
    1. Ang RE. Visual performance of a small-aperture intraocular lens: first comparison of results after contralateral and bilateral implantation. J Refract Surg 2020; 36:12–19.
    1. Dick HB, Elling M, Schultz T. Binocular and monocular implantation of small-aperture intraocular lenses in cataract surgery. J Refract Surg 2018; 34:629–631.
    1. Hooshmand J, Allen P, Huynh T, et al. Small aperture IC-8 intraocular lens in cataract patients: achieving extended depth of focus through small aperture optics. Eye (Lond) 2019; 33:1096–1103.
    1. Grabner G, Ang RE, Vilupuru S. The small-aperture IC-8 intraocular lens: a new concept for added depth of focus in cataract patients. Am J Ophthalmol 2015; 160:1176–1184.
    1. Agarwal P, Navon SE, Subudhi P, Mithal N. Persistently poor vision in dim illumination after implantation of XtraFocus small-aperture IOL (Morcher). BMJ Case Rep 2019; 12:e232473.
    1. Cochener B. Clinical outcomes of a new extended range of vision intraocular lens: International Multicenter Concerto Study. J Cataract Refract Surg 2016; 42:1268–1275.
    1. Pedrotti E, Bruni E, Bonacci E, Badalamenti R, Mastropasqua R, Marchini G. Comparative analysis of the clinical outcomes with a monofocal and an extended range of vision intraocular lens. J Refract Surg 2016; 32:436–442.
    1. Tarib I, Kasier I, Herbers C, et al. Postoperative results in patients implanted with a novel enhanced depth of focus lntraocular lens. EC Ophthalmology 2018; 9:192–202.
    1. AT LARA family: The next generation EDoF IOLs with wider range of focus - ZEISS Medical Technology. Available at: . Accessed May 4, 2020.
    1. Akondi V, Pérez-Merino P, Martinez-Enriquez E, et al. Evaluation of the true wavefront aberrations in eyes implanted with a rotationally asymmetric multifocal intraocular lens. J Refract Surg 2017; 33:257–265.
    1. Cataract & Refractive Surgery Today Europe: Experts Uncover The Next Genreation of Lentis IOLs. Available at: . Accessed February 6, 2020.
    1. García-Domene MC, Felipe A, Peris-Martínez C, Navea A, Artigas JM, Pons ÁM. Image quality comparison of two multifocal IOLs: influence of the pupil. J Refract Surg 2015; 31:230–235.
    1. LUCIDIS – Swiss Advanced Vision. Available at: . Accessed February 5, 2020.
    1. Gillmann K, Mermoud A. Visual performance, subjective satisfaction and quality of life effect of a new refractive intraocular lens with central extended depth of focus. Klin Monbl Augenheilkd 2019; 236:384–390.
    1. Nivean M, Nivean PD, Reddy JK, et al. Performance of a new-generation extended depth of focus intraocular lens—a prospective comparative study. Asia Pac J Ophthalmol (Phila) 2019; 8:285–289.
    1. InFo Swiss Made EDOF IOL Premium Hybrid Design. Available at: . Accessed February 5, 2020.
    1. EDEN – Swiss Advanced Vision. . Accessed February 5, 2020.
    1. HARMONIS – Swiss Advanced Vision. Available at: . Accessed February 5, 2020.
    1. Cochener-Lamard B. Multifocal Intraocular Lenses: The Johnson and Johnson Family of Lenses. In: Alió JL, Pikkel J, eds. Multifocal Intraocular Lenses: The Art and the Practice, 2nd Ed. Essentials In Ophthalmology. Cham, Switzerland: Springer International Publishing; 2019:249–274.
    1. MacRae S, Holladay JT, Glasser A, et al. Special report: American Academy of Ophthalmology Task Force Consensus Statement for extended depth of focus intraocular lenses. Ophthalmology 2017; 124:139-141.
    1. Titiyal JS, Kaur M, Bharti N, Singhal D, Saxena R, Sharma N. Optimal near and distance stereoacuity after binocular implantation of extended range of vision intraocular lenses. J Cataract Refract Surg 2019; 45:798–802.
    1. Alió JL, Pikkel J. Multifocal Intraocular Lenses: Neuroadaptation. In: Alió JL, Pikkel J, eds. Multifocal Intraocular Lenses: The Art and the Practice, 2nd Ed. Essentials in Ophthalmology. Cham, Switzerland: Springer International Publishing; 2019:53–60.
    1. Grzybowski A, Kanclerz P, Muzyka-Woźniak M. Methods for evaluating quality of life and vision in patients undergoing lens refractive surgery. Graefes Arch Clin Exp Ophthalmol 2019; 257:1091–1099.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner