A nondiffractive extended vision intraocular lens (IOL), implanted when the nondominant eye is targeted for slight myopia, can improve near vision in patients undergoing routine cataract surgery interested in spectacle independence, according to research published in the Journal of Cataract and Refractive Surgery.
The investigators conducted a prospective, unmasked, nonrandomized clinical trial at a single site to evaluate objective and subjective visual outcomes associated with bilateral implantation of the the AcrySof® IQ Vivity® nondiffractive extended vision IOL when the dominant eye was targeted for emmetropia and the non-dominant eye was targeted for slight monovision (-0.50 D to -0.75 D). Patients undergoing routine cataract surgery in both eyes who were 50 years of age or older and interested in presbyopia correcting lenses were recruited for the study (ClinicalTrials.gov Identifier: NCT05464732).
The primary outcome was uncorrected binocular near visual acuity (VA) (at 40 cm) 3 months after surgery; distance (4 m) and intermediate (66 cm) VA were also measured. Patients completed questionnaires on visual disturbances, satisfaction, and spectacle independence at the preoperative and postoperative visits.
A total of 31 patients (mean age, 69±6 years; range, 52-78 years; 68% women and 32% men) were evaluated after implantation with the nondiffractive extended vision IOL.
At postoperative month 3, the mean refractive spherical equivalent was 0.45 D more myopic in the nondominant eye. The investigators found this resulted in worse uncorrected VA at distance but better uncorrected VA at near. They reported all but a single patient implanted with the nondiffractive extended vision IOL had 0.3 logMAR or better binocular near VA and all patients had a near VA of 0.4 logMAR or better.
The most frequently reported visual disturbances included glare (16%), blurred vision (10%), and starbursts (19%). Visual disturbances were not correlated with differences in refraction, but glare and blurred vision were significantly correlated with overall satisfaction with the .
“Clinical results with the lens when implanted with a target of emmetropia in both eyes indicate that patients achieve excellent uncorrected visual acuity at distance and intermediate foci, though near vision is (as expected) not as good,” explain the study authors. “The frequency and severity of visual disturbances were reported to be similar to those experienced with a monofocal IOL.”
Limitations of the study included lack of a separate control participants group and no masking of the examiner for VA and defocus curve testing.
Disclosure: Some study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Solomon KD, Sandoval HP, Potvin R. Visual outcomes, satisfaction and spectacle independence with a non-diffractive extended vision intraocular lens targeted for slight monovision. J Cataract Refract Surg. Published online March 30, 2023. doi:10.1097/j.jcrs.0000000000001191