Clinical Outcome And Patient Satisfaction With A New Non-Diffractive Extended Depth-Of-Focus (Edof) Intraocular Lense (Isopure®)

To evaluate clinical outcomes after bilateral cataract surgery with implantation of Isopure^® (BVI) in a large cohort of cataract patients in terms of visual acuity (distance, intermediate and near), binocular defocus curves, spectacle independence and patients-reported photic phenomena.

Vista Alpina Eye Clinic, Visp, Switzerland

Single-center retrospective study including 124 eyes of 62 patients with ≤ 1.5 D regular corneal astigmatism, who underwent immediately consecutive bilateral cataract surgery with implantation of Isopure^® (BVI).

Mini-monovision (-0.5 diopters in the non-dominant eye) was used in all patients, and algorithm-guided opposite clear corneal incisions were applied in 68 eyes with pre-existing corneal astigmatism from 0.6 D up to 1.5 D.
One-month postoperative examination included: visual acuity at 4m, 80cm and 40cm, binocular defocus curve from +2.0 to -3.0 D (step size 0.5 D), spectacle independence (PRISQ questionnaire) and subjective ratings of picture-referenced photic phenomena (modified NEI Quality of Vision questionnaire (RQL-42)).

Postoperative monocular corrected distance visual acuity (CDVA) was -0.04 ± 0.07 logMAR (n = 124). Monocular uncorrected distance visual acuity was 0.06 ± 0.11 logMAR in plano eyes (n =62).
Binocular uncorrected visual acuity was:

• distance: -0.02 ± 0.07 logMAR
• intermediate: 0.13 ± 0.11 logMAR
• near: 0.40 ± 0.20 logMAR

The binocular defocus curve showed a smooth slope, and at 0.2 logMAR (or better) the curve extended from -1.5 D (~67cm) to +1.0D.
96.4% of patients felt comfortable seeing far without glasses, 94.6% at intermediate distance, and 34.0 % at near. Five percent of patients reported halos, 16% starburst, and 16% glare when confronted with reference pictures. Only 7% (n=4) of patients were disturbed by them in everyday life.

In patients undergoing bilateral cataract surgery, Isopure^® provided an extended range of functional vision up to 67cm, resulting in usable uncorrected near vision, good uncorrected intermediate vision and excellent uncorrected distance vision.Subjective patient satisfaction in terms of spectacle independence and photic phenomena were high. The excellent CDVA further underlines the safety of the Isopure^® IOL.