Initial Experience With A Single-Piece Enhance Monofocal Intraocular Lens Designed To Slightly Extend Depth Of Focus

To evaluate the visual and refractive outcomes of a single-piece acrylic enhanced monofocal intraocular lens designed to slightly extend depth of focus.

Multidisciplinary private hospital.

Prospective consecutive case series study. Inclusion criteria were eyes with visually significant cataracts and pre-existing corneal astigmatism less than 0.75D. 20 patients with bilateral implantations were evaluated with all operations performed by a single surgeon in a standard manner. Post-op refractive targeting objectives were based on a mini- monovision strategy. Outcome measures were binocular visual acuities for distance and near, refractive predictability, defocus curves and reported dysphotopsia.

All 20 patients achieved 20/40 (LogMar 0.3) or better for distance, 19 patients (95%) 20/30, 18 (90%) 20/25 and 14 (70%) 20/20. For near, 18 (90%) patients could manage J3 binocularly, 14 (70%) patients J2 and 4 (20%) J1. All eyes with post- op refraction between -0.75D and -1.25D could read J3 or better under photopic conditions when tested monocularly. Using the Barrett Universal II IOL formula, all 40 eyes were within 0.75D of predicted post-op refraction, 85% within 0.50D and 60% within 0.25D. On testing for distance corrected binocular defocus tolerance, LogMAR vision of 0.12 (~20/26) was seen with -0.75D of defocus, and LogMAR 0.16 (~20/29) was obtained with -1.00D of defocus. No haloes or glare symptoms were reported by any patient.

This enhanced monofocal IOL was found to provide good visual and predictable refractive outcomes at one month post-op. Good binocular functional near vision was achieved by off-setting post-op refraction by -0.75D to -1.25D in the non-dominant eye. The IOL was well-tolerated by patients, with minimal dysphotopsia reported.