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Purpose To evaluate the visual performance of an extended depth of focus (EDOF) intraocular lens (IOL) for patient selection. Methods This prospective non-comparative case series evaluated fifty-two eyes (26 patients) after bilateral implantation of the Tecnis Symfony IOL. Exclusion criteria were previous ocular surgeries, corneal astigmatism of >1.5 diopter, and ocular pathologies or corneal abnormalities. Uncorrected (UCVA) and distance-corrected (DCVA) visual acuity (VA) in 4 m, 80 cm, 60 cm and 40 cm (logMAR), defocus curve, contrast sensitivity (CS) and a questionnaire on subjective quality of vision (QoV) were assessed after 3 months. Results UCVA was −0.02 ± 0.071 logMAR at 4 m, 0.01 ± 0.077 logMAR at 80 cm, 0.08 ± 0.187 logMAR at 60 cm and 0.22 ± 0.153 logMAR at 40 cm. Defocus curve testing showed a flat VA range from 0.00 to −1.50 D (−0.05-0.02 logMAR). At near distance from −2.0 to −2.5 D a dip of DCVA was observed (0.14-0.28 logMAR). CS under photopic and mesopic conditions without and with glare was 1.56 logCS, 0.86 logCS, 0.78 logCS, respectively. Spectacle independence was achieved in 100% for distance and intermediate vision and 71% of patients at near distance. Conclusion This EDOF IOL provides excellent intermediate and far (<0.1 logMAR) and acceptable near UCVA (<0.3 logMAR). Defocus curve testing confirmed an EDOF between far and intermediate distance and showed a dip at near distance. It provides good QoV, CS, high spectacle independence, perception of few optical phenomena, and particularly good night-driving capabilities.

Purpose: To compare the efficacy and safety of femtosecond laser–assisted cataract surgery (FLACS) with conventional cataract surgery (CCS). Setting: Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany. Design: Meta-analysis. Methods: PubMed, Cochrane Library, and EMBASE were systematically searched for studies comparing FLACS and CCS. Outcomes were efficacy and safety parameters. The effect measures were weighted mean differences or odds ratios with 95% CIs. Results: A total of 73 studies (25 randomized controlled, 48 observational) were reviewed with a total of 12 769 eyes treated with FLACS and 12 274 eyes treated with CCS. In eyes treated with FLACS, uncorrected and corrected distance visual acuities and spherical equivalent after 1 month to 3 months (P = .04, P = .005, and P = .007, respectively) were better, total and effective phacoemulsification times were shorter (P < .001 each), cumulative dissipated energy was less (P < .001), circularity was more accurate (P < .001), central corneal thickness after 1 day and 1 month to 3 months was less (P < .001 and P = .004, respectively), and endothelial cell loss after 3 to 6 weeks and 3 months was less (P = .002 and P < .001, respectively) compared with CCS. Anterior capsule ruptures occurred more often with FLACS. No significant differences among groups were found in visual acuity at 1 week and after 6 months or in posterior capsule rupture rates and endothelial cell loss after 6 months. Conclusions: Both FLACS and CCS are effective and safe. FLACS required less ultrasound energy and a more precise treatment. However, mid-term visual acuity did not show any difference between both methods.