<p>Visual Acuity, Defocus Curve, Reading Speed and Patient Satisfaction with a Combined Extended Depth of Focus Intraocular Lens and Multifocal Intraocular Lens Modality</p>

Abstract

Purpose To evaluate the vision, defocus curve, reading speed and patient satisfaction after implantation of an extended depth of focus (EDOF) IOL in one eye and a diffractive multifocal in the fellow eye. Setting One clinical practice in the USA. Design Prospective unmasked non-randomized clinical trial. Methods Subjects presenting for routine cataract surgery interested in reducing their dependence on spectacles were enrolled. Study endpoints included uncorrected and distance-corrected binocular distance (4 m), intermediate (66 cm) and near (40 cm) visual acuity at 3 months. Additional endpoints included the residual refraction, spectacle independence, overall satisfaction with vision, visual symptoms, reading speed and defocus curve. Results With a best distance correction, 77% (30/39) of subjects had 20/25 or better VA at distance, intermediate and near and nearly all subjects had 20/32 or better VA at all three distances. Defocus curve results showed mean continuous vision of 20/25 or better from plano to −2.50 D. Nearly 80% (31/39) of subjects had 20/25 visual acuity from 0.00 D to −2.50 D. The critical print size was between 0.3 and 0.4 logMAR (20/40 to 20/50 Snellen Equivalent). Spectacle independence was 100% at distance, 95% at intermediate and approximately 70% at near. The percentage of subjects who were “not at all” or “slightly” bothered by visual disturbances ranged from 64% (16/25) for Halos to 88% (22/25) for Starbursts. Conclusions EDOF/bifocal IOL blended implantation results in at least 20/25 mean visual acuity from distance to near with good spectacle independence and low reports of severe visual disturbances.

Visual acuity, defocus curve and patient satisfaction of a new hybrid EDOF-multifocal diffractive intraocular lens

“…The binocular defocus curve result of the current study showed a flat peak around 0.00 logMAR between 0.0 and +0.5 D power, followed by a flat intermediate visual acuity zone around 0.10 logMAR between −1.0 and −2.0 D power, ending with a narrow near visual cuity zone around 0.15 – 0.20 logMAR between −2.5 and −3.0 D power. The dip point around 0.10 – 0.15 logMAR in −0.5 D power gives the defocus curve an appearance similar to previously reported defocus curves of multifocal IOLs including Alcon PanOptix and Zeiss AT LISA lenses, 18,25,33,34 depicting a slightly worse continuous visual acuity performance that was provided by EDOF IOLs. 11,28 Interestingly, the defocus curve shows a good performance that is above 0.10 logMAR units between 0.0 and +1.0 D power, therefore a postoperative myopic refractive “surprise” might be well tolerated.…”

Comparative Analysis of a New Hybrid EDOF-Multifocal Diffractive Intraocular Lens with a Trifocal Diffractive Intraocular Lens

“…Comparative analysis has shown that ZFR00V had slightly better far-to-intermediate range of vision against TFNT00. The dip point around 0.10–0.15 logMAR in −0.5 D power for ZFR00V IOL was found comparable to TFNT00 IOL, giving an appearance of a multifocal IOL defocus curve similar to previously reported defocus curves for TFNT00 and Zeiss AT LISA lenses, 18,25,32,33 depicting a slightly worse continuous visual acuity performance that was provided by EDOF IOLs. 11,28 The defocus pattern of the current study had similarities with the study held by Ribeiro et al which showed mean visual acuity above 0.10 LogMAR between + 0.50 D and −3.00 D. 31 ZFR00V lens showed a good performance between 0.0 and + 1.0 D powers which was above 0.10 logMAR units, therefore targeting a slight postoperative myopic refractive target might be advisable to further enhance continuous far-to-intermediate vision.…”

The Effect of Spectacle-Induced Low Myopia in the Non-Dominant Eye on the Binocular Defocus Curve with a Non-Diffractive Extended Vision Intraocular Lens

“…Some surgeons will use a combination of these approaches. 1,2 The multifocal IOLs, particularly the trifocals, generally provide the highest likelihood of complete spectacle independence. [3][4][5] EDOF lenses are likely to provide good vision at distance and intermediate, with slightly worse near vision, but the expectation is that visual disturbances will be lower with an EDOF IOL because there are not two (or three) distinct foci.…”