Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma

Abstract

Purpose To evaluate the clinical outcomes of a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) in eyes with mild open-angle glaucoma (OAG). Setting Private practice; Sioux Falls, South Dakota. Design Prospective, open-label, interventional study. Methods In total, 52 eyes of 26 patients with mild OAG were enrolled and completed the study. All patients were bilaterally implanted with a non-diffractive, wavefront-shaping EDOF IOL. Seventy-seven percent of the patients were implanted with a trabecular microbypass stent at the time of surgery. Primary outcome measures included binocular corrected and uncorrected distance visual acuity (CDVA and UDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA) and contrast sensitivity as measured by a Pelli-Robson chart. A subjective questionnaire was also administered to patients. Results At 4 months postoperative, the mean binocular UDVA and CDVA was 0.03 ± 0.12 and −0.06 ± 0.07, respectively. The mean UIVA and UNVA were 0.18 ± 0.12 and 0.31 ± 0.18, respectively. Eighty-five percent of the subjects achieved ≥20/25 UDVA and 77% of the subjects achieved ≥20/32 UIVA at 4 months postoperative. The mean binocular mesopic contrast sensitivity was 1.76 ± 0.16 at a spatial frequency of 1 cycle-per-degree (cpd). Eighty-five percent of the subjects reported they would choose the same lens and 1 subject reported they would choose a different IOL if it meant reduced spectacle independence. Conclusion The non-diffractive, wavefront-shaping EDOF IOL can be safely implanted in eyes with mild, pre-perimetric open-angle glaucoma with favorable uncorrected distance and intermediate visual acuity. The contrast sensitivity measurements were favorable and the subjective questionnaire revealed satisfactory spectacle independence and patient satisfaction.

Premium Intraocular Lenses in Glaucoma—A Systematic Review

“…Full-text assessment was performed on the remaining 13 records; 2 were not retrieved, and 1 additional study was included from citation searching ( Figure 1 ). Twelve studies [ 22 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] fulfilled the inclusion criteria.…”

“…Three studies originated from the USA, four studies from Japan, three studies from Spain, one study from Australia, and one study from the UK. Three studies [ 40 , 41 , 49 , 50 ] reported on EDOF IOL outcomes, six studies [ 22 , 42 , 44 , 45 , 46 , 47 ] reported on toric IOL outcomes, one study [ 48 ] reported on MFIOL outcomes, and one study [ 43 ] reported outcomes from EDOF, bifocal, and trifocal IOL implantation. Study characteristics (author, publication year, sample size, age range, IOL type, surgery type, and outcomes) were extracted and summarized in Tables S2–S4 (Supplementary Material) .…”

“…Five studies [ 22 , 40 , 43 , 49 , 50 ] reported on spectacle independence in glaucomatous eyes. Ferguson et al [ 40 ] implanted 52 eyes with mild open angle glaucoma with EDOF non-toric or toric IOLs (AcrySof IQ Vivity/AcrySof IQ Vivity Toric, Alcon Laboratories, Fort Worth, TX, USA) and demonstrated a high rate of spectacle independence post-operatively in both toric and non-toric IOL groups (spectacle independence rates: 92% for distance tasks; 50% for intermediate tasks; and 38% for near tasks).…”

“…Five studies [ 22 , 40 , 43 , 49 , 50 ] reported on spectacle independence in glaucomatous eyes. Ferguson et al [ 40 ] implanted 52 eyes with mild open angle glaucoma with EDOF non-toric or toric IOLs (AcrySof IQ Vivity/AcrySof IQ Vivity Toric, Alcon Laboratories, Fort Worth, TX, USA) and demonstrated a high rate of spectacle independence post-operatively in both toric and non-toric IOL groups (spectacle independence rates: 92% for distance tasks; 50% for intermediate tasks; and 38% for near tasks). Ouchi et al [ 22 ] implanted 15 eyes (11 patients) with coexisting ocular pathologies (including 4 glaucoma eyes—1 with acute angle closure glaucoma; 3 with normal tension glaucoma) with MFIOLs (LENTIS MPlus LS-313MF30 and the LENTIS Mplus Toric LU-313MFT (Oculentis GmbH, Berlin, Germany)).…”

Comparison of the Visual Outcomes of Enhanced and Standard Monofocal Intraocular Lens Implantations in Eyes with Early Glaucoma

“…Previous studies have shown that patients with glaucoma may experience decreased CS after bifocal IOL implantation [ 7 , 9 , 11 ]. However, in a prior study, a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) IOL provided good visual acuity and high patient satisfaction in eyes with mild, pre-perimetric open-angle glaucoma (OAG) [ 12 ]. In addition, EDOF IOLs have been reported to provide similar CS and VF outcomes to those of standard monofocal IOLs in cataract patients without ocular comorbidities [ 13 , 14 , 15 ].…”