Evaluation Of Patient' Satisfaction And Quality Of Vision After Bilateral Implantation Of Extended Depth Of Focus Intraoular Lens (Edof Iol) Compared To Trifocal Iol: A Randomized Clinical Trial

To evaluate patient's satisfaction and visual outcomes after bilateral implantation of extended depht of focus intraocular lens (EDOF) compared to bilateral implantation of a trifocal IOL.

Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

This randomized single blind clinical trial included 32 patients without previous ocular comorbidities who underwent cataract surgery. Sixteen patients received bilateral EDOF IOLs (Miniwell in the dominant eye and Miniwell Proxa in the non dominant eye) while the other 16 patients were implanted bilaterally with a trifocal IOL. Three-month follow-up included: distance corrected and uncorrected visual acuity at 4m (DCVA and UDVA), 80cm (DCI80VA and UI80VA), 67cm, (DCI67VA and UI67VA) and 40cm (DCNVA and UNVA), binocular defocus curves, contrast sensitivity (CS), subjective and objective (Root mean square -RMS, point-spread-function -PSF- Strehl ratio) visual quality, and the NEI RQL 42 questionnaire was administerd. 

In the EDOF group binocular UDVA, UI80VA, UI67VA and UNVA were 0.10±0.10, 0.03±0.15, 0.03±0.15, -0.03±0.11 logMAR, respectively. The values obtained in the trifocal group were -0.07±0.06, 0.10±0.10, 0.00±0.10, -0.03±0.15 logMAR. The DCVA showed higher performances in both groups. All visual acuities at defocus curves were ≥0.06 logMAR and  ≥0.17 logMAR between +1.50 and -3.50 for trifocal and EDOF group, respectively. PSF Strehl ratio was 0.19±0.08 and 0.72±0.42 and RMS were 0.72±0.41 and 0.41±0.14 in the trifocal and EDOF group, respectively. In both grops CS were higher binocularly. Subjectively, the patients were more satisfied of their far and near vision and experienced less photic phenomena in the EDOF group. 

In this study both groups achieved very good visual acuities at all distances, with the EDOF group performing better in the intermediate distances and the trifocal group at the far distance. The EDOF group experienced the highest grade of satisfaction after three months experiencing less photic phenomena.