Implanting a presbyopia-correcting intraocular lens (IOL) with extended depth of focus (EDOF) after cataract surgery gave patients “functional levels of distance, intermediate, and near visual acuity,” potentially enhanced for near vision using a micro-monovision approach, according to a study in Clinical Ophthalmology.

The pilot study was designed to evaluate the clinical outcomes of a novel model of EDOF IOLs. Investigators evaluated 27 eyes of 16 patients who underwent uncomplicated phacoemulsification cataract surgery and IOL implantation. During the 3-month follow-up, near acuity —including uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA) — and distance visual acuity — including uncorrected and corrected distance visual acuity (UDVA and CDVA). The team also evaluated participants’ monocular defocus curve and refractive outcomes.

They found that mean postoperative UDVA, UNVA, and DCNVA were 0.11±0.17, 0.14±0.22, and 0.37±0.36 logMAR, respectively. Additionally, 84.6%, 91.7%, and 96.3% of eyes achieved postoperative UDVA, UNVA, and CDVA of 0.20 logMAR or better. Nearly 79% of eyes had a postoperative DCNVA of 0.30 logMAR or better. On average, distance-corrected visual acuity was maintained over a value of 0.30 logMAR for the range of defocus levels between +1.00 and -1.50 D. The mean postoperative spherical equivalent was -0.76±0.53 D. 

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The study did have limitations, including a small sample size (though the study was designed as a pilot study, researchers point out), but a larger sample is currently being recruited for further research; the IOL’s optical quality could not be examined because only visual acuity and refractive data were collected; and finally, the study was comparative so “the superiority of the performance of this EDOF IOL over a conventional monofocal IOL cannot be confirmed,” according to investigators.

“More research is still needed to evaluate the impact of this EDOF IOL on visual quality and its advantage over other presbyopia-correcting options that are currently available,” they conclude. “Furthermore, the results of this pilot study should be confirmed in future comparative clinical trials.”


Iradier MT, Cruz V, Gentile N, Cedano P, Piñero DP. Clinical outcomes with a novel extended depth of focus presbyopia-correcting intraocular lens: pilot study. Clin Ophthalmol. 2021;15(3):1215-1221. doi:10.2147/OPTH.S297985