EDOF Visual Disturbance Profile Similar to Monofocal IOL, But Visual Outcomes Better

Extended depth of focus (EDOF) visual disturbance profile is similar to that of monofocal intraocular lenses (IOLs), but the EDOF option provides superior spectacle independence as well as improved near and intermediate vision, according to findings published in Clinical Ophthalmology.

Patients (N=62) who underwent cataract surgery performed by a single surgeon at the Colvard-Kandavel Eye Center in the United States and received either bilateral implantation with EDOF (n=32; mean age, 72.4 (SD, 6.5) years; 53% men) or monofocal IOL (n=30; mean age, 71.9 (SD, 7.9) years; 40% men) were included in this analysis. Outcomes of monofocal IOL and EDOF visual disturbance profiles, visual acuity (VA), and defocus curves, were evaluated at a 3 month or longer follow-up. They received IOLs with powers of 20.17 (SD, 3.0) and 20.42 (SD, 3.4) D, respectively.

At the follow-up, the groups differed significantly for monocular corrected distance VA at 6 meters (mean, 0.02 vs -0.03 logMAR; P =.007), uncorrected intermedia VA at 66 centimeters (mean, 0.15 vs 0.24 logMAR; P <.001), distance-corrected intermediate VA at 66 centimeters (mean, 0.18 vs 0.25 logMAR; P <.001), uncorrected near VA at 40 centimeters (mean, 0.36 vs 0.59 logMAR; P <.001), and distance-corrected near VA at 40 centimeters (mean, 0.41 vs 0.56 logMAR; P <.001) for the EDOF and monocular IOL recipients, respectively. Similar trends were observed for binocular VA outcomes.

Most of the EDOF recipients reported never or rarely needing spectacles (74.2%) compared with less than half of the monofocal IOL recipients (43.3%; P =.035).

Without correction, the EDOF visual disturbance profile included starbursts (28.1%), halos (25%), glare (54.8%), blur (19.4%), and negative dysphotopsias (12.5%). The monofocal group, without correction, also experienced disturbances of starbursts (20.7%), halos (27.6%), glare (62.1%), blur (14.3%), and negative dysphotopsias (6.9%). In both groups the greatest disturbances were reported with daytime glare.

With correction, the EDOF visual disturbance profile was reduced to starbursts only in 3.1% of recipients. All other disturbances resolved completely. The corrected monofocal profile included starbursts (3.4%), Glare (3.4%), and blur (3.6%).

“Patients who undergo cataract surgery and IOL implantation have high expectations of spectacle independence. This is especially true for presbyopia correcting IOLs, which are typically premium IOLs requiring patients to pay extra out of pocket expenses,” the researchers explain.

The limitations of this study included the nonrandomized design and the analysis of a mixture of both retrospective and prospectively collected data.

Disclosures: This research was supported by Alcon Vision, LLC. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.