Visual outcomes of non-diffractive extended-depth-of-focus and enhanced monofocal intraocular lenses: A case-control study

Abstract

Objective To compare the visual outcomes of a non-diffractive extended-depth-of-focus (EDoF) intraocular lens (IOL) with an enhanced monofocal IOL. Methods We evaluated 76 eyes from 38 patients who had undergone bilateral cataract surgery with implantation of either an EDoF IOL (AcrySof IQ Vivity, n = 40 eyes) or an enhanced monofocal IOL (Tecnis Eyhance, n = 36 eyes). Objective refraction, monocular and binocular uncorrected and corrected distance visual acuity (UDVA, CDVA), uncorrected and distance-corrected intermediate visual acuity (UIVA, DCIVA), uncorrected and distance-corrected near visual acuity (UNVA, DCNVA), binocular defocus curves, contrast sensitivity, halo and glare perception, and spectacle independence were compared. Results Monocular and binocular UDVA, CDVA, UIVA, and DCIVA were comparable in both groups, whereas UNVA and DCNVA were significantly better with the Vivity group than with the Eyhance group. The two groups had no statistically significant difference regarding photopic and scotopic contrast sensitivities or halo and glare perception. Compared to the Eyhance IOL, the Vivity IOL had a larger landing zone in the defocus curve and provided higher spectacle independence for near vision. Conclusion Both the AcrySof IQ Vivity and Tecnis Eyhance IOLs had excellent distant and intermediate visual acuity, while the former had more satisfactory near vision outcomes with greater spectacle independence rate. No differences were obtained between two IOLs in terms of patient satisfaction and visual disturbances such as halo and glare.

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

“…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]. Interestingly, no significant differences were reported for visual acuities at intermediate vision [33][34][35].…”

“…General agreement was reported about a higher depth of focus range for EDOF lenses and statistically significant differences only at near vision [33][34][35]49]. Despite of the higher range of the depth of focus showed in the defocus curve and the statistically significant differences at near, no significant differences were reported for visual acuities at intermediate vision [33][34][35]. The comparison with the standard monofocals is presented in the next section.…”

“…Table 4 shows the endpoints described in each of the enhanced monofocal studies, and the Supplemental A file contains all data extracted from these studies. All the studies comparing EDoF lenses (Symfony, Eyecril SERT and Vivity) with enhanced monofocal lenses were conducted with the Tecnis Eyhance [33][34][35]49]. General agreement was reported about a higher depth of focus range for EDOF lenses and statistically significant differences only at near vision [33][34][35]49].…”

“…All the studies comparing EDoF lenses (Symfony, Eyecril SERT and Vivity) with enhanced monofocal lenses were conducted with the Tecnis Eyhance [33][34][35]49]. General agreement was reported about a higher depth of focus range for EDOF lenses and statistically significant differences only at near vision [33][34][35]49]. Despite of the higher range of the depth of focus showed in the defocus curve and the statistically significant differences at near, no significant differences were reported for visual acuities at intermediate vision [33][34][35].…”

“…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.…”