Comparative Analysis of the Clinical Outcomes of Mix-and-Match Implantation of an Extended Depth-of-Focus and a Diffractive Bifocal Intraocular Lens

Abstract

Objectives: To evaluate and compare the clinical outcomes of the extended depth-of-focus intraocular lens (EDOF-IOL) and the diffractive bifocal IOL. Methods: Fifty-six eyes of 28 patients underwent cataract surgery with implantation of an EDOF-IOL (TECNIS Symfony, ZXR00) in their dominant eye and a diffractive bifocal IOL (+3.25 D add TECNIS ZLB00) in their nondominant eye. Monocular and binocular uncorrected distance, intermediate and near visual acuity, defocus curves, contrast sensitivity, patient satisfaction score (0-5), and spectacle dependence at near vision were evaluated at 3 months after the surgery. Results: Postoperative binocular uncorrected distant visual acuity was 0.00960.031 logMAR, uncorrected intermediate visual acuity was 0.09060.158 logMAR, and uncorrected near visual acuity was 0.09960.068 logMAR. The monocular defocus curve demonstrated better performance at intermediate distance in eyes with an EDOF-IOL and better performance at near distance in eyes with a diffractive bifocal IOL. An EDOF-IOL exhibited better outcomes in contrast sensitivity compared with a diffractive bifocal IOL. Three patients (10.7%) required glasses for near vision. Conclusion: Mix-and-match implantation of a diffractive bifocal IOL with an EDOF-IOL provides an excellent range of vision, and high levels of contrast sensitivity and patient satisfaction.

A Comparative Study of Two Extended Depth of Focus Intraocular Lenses

“…According to previous studies, UDVA and CDVA were similar between EDOF and monofocal IOL. 27,28 Earlier studies have reported monocular UDVAs of 0.1360.13, 29 0.0160.09, 30 and 0.0260.04 31 for Symfony and 0.1260.14, 28 0.0060.08, 32 , and 20.0160.07 33 Vivity. Earlier studies have reported monocular CDVAs of 20.0560.06, 30 0.0160.03, 34 and 0.0560.08 29 for Symfony and 0.0160.05, 28 20.0260.06, 32 and 20.0160.06 33 for Vivity.…”

“…19 Compared with diffractive trifocal IOLs, EDOF IOLs have low incidence rates of postoperative visual symptoms such as photic phenomena. 31 Another study indicated that Symfony IOL implantation was associated with a lower incidence of postoperative visual disturbance and a lower level of subjective perception than trifocal IOL. 25 There was no distinction between the two groups in any of the optical quality parameters (Table 3).…”

Comparision of a Novel Trifocal Intraocular Lens and a Monofocal Enhanced Depth of Focus Intraocular Lens in Visual Performance and Quality of Life Scores

“…This extended focal plane can be achieved through the modi cation of spherical aberrations, diffractive optical designs, pinhole effect, or bio-analogical Technologies [11]. Nowadays, to achieve better visual performance, one or more of the available IOL technologies in the market can be combined [12].…”

Comparative analysis of a presbyopia-correcting intraocular lens that combines extended depth-of-focus and bifocal profiles with a standard monofocal intraocular lens

“…Consistent with this trend, the ratio of multifocal (bifocal or trifocal), or extended depth-of-focus (EDOF) IOL implantations is increasing [4]. Different bifocal IOL platforms were implanted in the past, but currently, the most common presbyopia correcting IOLs implanted, include on the one hand the trifocal models, like the PanOptix (Alcon Laboratories Inc., Fort Worth, TX, USA), Fine-Vision Micro F IOL (PhysIOL, Liège, Belgium), Acriva Reviol Tri-ED 611 (VSY Biotechnology, Amsterdam, The Netherlands), and AT Lisa tri (Carl Zeiss Meditec AG, Jena, Germany), and on the other hand, modern EDOF like the Symfony (Johnson & Johnson Vision Inc., Santa Ana, CA, USA), or Vivity (Alcon Laboratories Inc., Fort Worth, TX, USA) IOLs [4,5].…”