Isofocal Extended Depth-of-Focus IOLs Earn High Patient Satisfaction Marks

Isofocal extended depth-of-focus (EDOF) intraocular lens (IOL) provide useful uncorrected near vision, good uncorrected intermediate vision, and excellent uncorrected distance vision, with high satisfaction in patients undergoing same-day bilateral cataract surgery, according to research published in Clinical Ophthalmology. 

“With growing patient expectation of spectacle-independence after cataract surgery, more and more IOL designs are being introduced that aim to provide good uncorrected visual acuity at various distances while minimizing photic phenomena,” explain researchers.

Researchers conducted a single-center retrospective study of 124 eyes from 62 patients (mean age, 70.6±7.4 years; 56% men and 44% women) who underwent bilateral implantation of an isofocal extended depth-of-focus lens with mini-monovision (-0.50 D). They assessed refraction and vision outcomes as well as spectacle independence and subjective ratings of picture-referenced photic phenomena using validated questionnaires at 1 to 2 months postoperatively.

The researchers report a mean postoperative refractive spherical equivalent of -0.15±0.41 diopters (D) in the dominant eyes and -0.46±0.35 D in the mini-monovision eyes (P <.01) and 98.4% of eyes were within ±1.0 0D of the target refraction. 

They also report that the isofocal extended depth-of-focus lenses resulted in mean postoperative monocular corrected distance visual acuity of -0.04±0.07 logMAR and binocular uncorrected visual acuity of -0.02±0.07 for far, 0.13±0.11 for intermediate, and 0.40±0.20 logMAR for near distances. 

Most patients reported spectacle-independence for far (96%) and intermediate (95%) distance, while 34% reported spectacle-independence for near distance. In the photic phenomena assessment, some patients reported halos (5%), 16% starburst (16%), and glare (16%), but only 7% of patients reported that isofocal extended depth-of-focus lenses were bothersome in daily life.

“[T]he rates of reported photic phenomena in our study can be deemed low compared to most other studies with EDOF or multifocal IOLs, considering the methodology (image-referenced) and timing (one to two months after surgery) of the questionnaire, as well as the use of mini-monovision,” according to the study authors.

Limitations of the study included the retrospective and non-comparative design, measurement of visual acuity at distances different than those more commonly used in clinical studies and for the ANSI EDOF criteria (ANSI Z80.35–2018), and the relatively short follow-up period.