Analysis of higher-order aberrations in relation to the clinical outcome of an enhanced monofocal IOL

Abstract

Purpose To analyse higher-order aberrations of an enhanced monofocal aspheric intraocular lens (IOL) in relation to the clinical outcome compared to a monofocal aspheric IOL. Setting Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Germany Design Prospective, monocentric, controlled, non-randomized, two-armed study Methods After phacoemulsification, a total of 30 patients (60 eyes) were bilaterally implanted with either TECNIS Eyhance IOL model ICB00 (Johnson & Johnson Surgical Vision, Inc.) or TECNIS Monofocal 1-Piece IOL model ZCB00 (Johnson & Johnson Surgical Vision, Inc.) in 30 eyes each. Assessments were performed 1 and 3 months after surgery including refraction, uncorrected and best-corrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivities under photopic, mesopic and mesopic conditions with glare, higher-order aberrations (HOAs) at pupil sizes of 5, 4, 3 and 2 mm and patient satisfaction. Results At 3-month follow-up, measurements of HOAs revealed significant higher negative internal and ocular primary spherical aberrations in the ICB00 group at pupil sizes of 5, 4, 3 and 2 mm. The ICB00 showed significant better results in intermediate and near visual acuity, but no difference in distance visual acuity. No significant difference was found in contrast sensitivities at any condition or spatial frequency. Spectacle independence was significant better without significant higher rates of dysphotopsia in the ICB00 group. Conclusions Higher negative spherical aberrations in the ICB00 group at all measured pupil sizes appear to lead to a superior clinical outcome in intermediate and near vision compared to the ZCB00 group without compromising contrast sensitivity or distance visual acuity.

Positioning of enhanced monofocal intraocular lenses between conventional monofocal and extended depth of focus lenses: a scoping review

“…Our scoping review also included three cases series that were not included in the previous ones, [17,37,44] but the results provided in these three references were in agreement with the conclusions reported by Wan et al [6]. This scoping review also included a comparison study for IsoPure [44] IOL in contrast to previous systematic reviews that only included Tecnis Eyhance.…”

“…Regarding the laboratory evidence, the elevation changes for refractive EDoF lenses were not achieved for Table 5 Criteria accomplished by the enhanced monofocals according to the ANSI standard definition of EDOF lenses and additional points RCT Randomized clinical trial, CS Case series ANSI-1: Statistical significance versus control for mean monocular visual acuity, with distance correction, at an intermediate distance of 66 cm ANSI-2: An increase in depth of field is achieved in the monocular defocus curve with distance correction equal to or greater than 0.5 D for a visual acuity level of 0.2 logMAR ANSI-3: The median monocular visual acuity, with distance correction, at an intermediate distance of 66 cm, is at least 0.2 logMAR ANSI-4: Monocular acuity at distance, with correction at this distance, is statistically non-inferior to control using a non-inferiority margin of 0.1 logMAR Add-1: Statistical significance versus control for mean binocular visual acuity, with distance correction, at an intermediate distance of 66 cm Add-2: An increase in depth of field is achieved in the binocular defocus curve with distance correction equal to or greater than 0.5 D for a visual acuity level of 0.2 logMAR Add-3: The mean monocular visual acuity, with distance correction, at an intermediate distance of 66 cm, is at least 0.2 logMAR Add-4: Starting with CDVA, the monocular defocus range at 0.2 logMAR is ≥ 1.5 and < 2. Bova et al [44], Nanavaty et al [39], Corbelli et al [49], Lopes et al [40], Steinmüller et al [17], Auffarth et al [45], Ucar et al [37], Kang et al [41], Unsal et al [38], Cinar et al [42], Huh et al [28], Yangzes et al [36], Eguileor et al [43], Mencucci et al [3], Garzón et al [46] the Tecnis Eyhance [31,32], and the optical quality studies that included both, enhanced monofocals and EDoF lenses, showed a higher depth of focus range with poorer distance optical quality for EDoF lenses in comparison to enhanced monofocals [25,27]. These laboratory results were in agreement with clinical evidence of studies including enhanced monofocals and EDoF lenses, demonstrating a higher range of focus and better DCNVA for the latter [33][34][35]49].…”

“…After the full text evaluation, three clinical studies were excluded since the inclusion criteria was not accomplished, [11][12][13] and one mixed was maintained (partly excluded) since the criteria was accomplished in the laboratory study context but not in the clinical [14]. During the search update in the moment of data extraction, three papers were included, two not indexed in the databases and found through snowballing techniques, [15,16] and 1 new after search update [17]. Finally, 38 studies were included in the data extraction process (Fig.…”

“…Three clinical studies compared enhanced monofocals with EDoF lenses, [33][34][35] 14 compared the clinical results with a standard monofocal, [3,17,28,[36][37][38][39][40][41][42][43][44][45][46] and three case series without a comparison group were identified [16,47,48] Only one study included both monofocal and EDoF lenses in comparison to Tecnis Eyhance [49]. Supplemental file B contains all the data extracted from clinical studies.…”

Clinical outcomes and optical performance of a new segmental refractive extended depth-of-focus intraocular lens

“…The contrast sensitivity results aligned with those of monofocal lenses investigated by our research group. [11][12][13] Several independent studies consistently emphasize the exceptional contrast vision achieved with refractive segmental IOLs, conclusively establishing their equivalence with monofocal IOLs. [21] This remarkable consistency in contrast vision performance underscores the clinical value of refractive segmental IOLs in ensuring excellent post-operative vision quality.…”