ESCRS - FP09.05 - Unilateral Intraindividual Comparison And Bilateral Performance Of A Monofocal Spherical And Diffractive Enhanced Depth Of Field Intraocular Lens Mix-And-Match Hybrid Monovision Approach

Unilateral Intraindividual Comparison And Bilateral Performance Of A Monofocal Spherical And Diffractive Enhanced Depth Of Field Intraocular Lens Mix-And-Match Hybrid Monovision Approach

Published 2023 - 41st Congress of the ESCRS

Reference: FP09.05 | Type: Free paper | DOI: 10.82333/1cvx-tc33

Authors: Jascha Wendelstein* 1 , Theo Guenter Seiler 2 , Marina Casazza 3 , Kamran Riaz 4 , Siegfried Mariacher 3 , Matthias Bolz 3

1IROC,Zürich,Switzerland;Kepler University hospital,Linz,Austria;Saarland University,Saarland,Germany, 2IROC,Zürich,Switzerland;University Hospital Bern,Bern,Switzerland;University Hospital Duesseldorf,Duesseldorf,Germany, 3Kepler University Hospital,Linz,Austria, 4e) Dean A. McGee Eye Institute / University of Oklahoma,Oklahoma City,United States

Purpose

We sought to evaluate a mix-and-match approach with a monofocal spherical IOL and a diffractive-optics aspheric EDOF IOL through an intraindividual comparison method. This synergistic approach aims to combine the strengths of each IOL to minimize the potential limitations of each. It offers a solution to patients that received previous unilateral cataract surgery with monofocal IOLs and desire more spectacle independence after second eye cataract surgery. Bilateral performance, in term of distance, intermediate and near visual acuity (corrected and uncorrected), contrast sensitivity, reading speed, and patient satisfaction with a monofocal/EDOF hybrid monovision is described.

Setting

Tertiary Care Setting (Kepler University Hospital Linz, Austria)

Methods

Single center, retrospective consecutive case series. Inclusion of patients after uneventful cataract surgery implantation of a spherical monofocal IOL in the dominant eye and a diffractive EDOF IOL in the nondominant eye. Bilateral performance, in terms of best-corrected and uncorrected distance (BCDVA and UDVA), intermediate(DCIVA and UIVA), and near visual acuity (DCNVA and UNVA), along with defocus curves, were evaluated. Bilateral reading speed, contrast sensitivity, and patient satisfaction using QOV, Catquest 9SF, and glare/halo questionnaires are reported.

Results

A total of 29 patients (58 eyes) were included. Between both IOLs, we found statistically significant differences for defocus steps of -1.0 dpt to -3.5 dpt. Comparing binocular visual acuity between the distance corrected group and the group with a defocus of 1.5 dpt for the EDOF-eye, we found statistically significant differences for defocus steps of -0.5 dpt to -4.0 dpt. We observed statistically significant differences between the spherical monofocal and EDOF IOL for DCIVA, DCNVA, UIVA, and UNVA. There were no statistically significant differences in UDVA and BCDVA. 93.10% of patients reported they would opt for the same combination of IOLs.

Conclusions

The described mix-and-match hybrid monovision approach utilizing a spherical IOL and EDOF-IOL offers surgeons an efficacious strategy to provide patients with favorable visual acuity at all distances with minimal deleterious photic phenomena. Excellent corrected and uncorrected distance visual acuity was demonstrated in both groups. The mix-and-match approach for hybrid monovision described in this study yielded a good intermediate vision and improved near vision with high patient satisfaction.