A Comparative Evaluation Of 2 Extended Depth-Of-Focus Intraocular Lenses In Cataract Surgery: Results Of A Prospective Randomized Trial

The aim of the present study is to compare clinical outcomes and subjective experience after bilateral implantation of two different optical designs of extended depth-of-focus (EDOF) intraocular lenses (IOLs): AcrySof® IQ Vivity® (Alcon AcrySof IQ Vivity) and Tecnis Symfony® (Johnson & Johnson Vision, Santa Ana, CA, US).

A single center, prospective, single-masked, randomized, controlled trial was conducted at the Republic of San Marino State Hospital.

Patients undergoing bilateral cataract surgery were randomized for bilateral implantation with either AcrySof® IQ Vivity® or Tecnis Symfony®. A detailed preoperative evaluation was performed including monocular uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) at distance, intermediate, and near. At 3-month follow-up, the tested outcomes were monocular distance, intermediate, near UCVA and BCVA, refractive changes, defocus curves, photopic and mesopic binocular contrast sensitivity, and photic phenomena perception tested by the Halo & Glare Simulator. Moreover, subjective patient satisfaction was evaluated by the administration of the Quality of Vision questionnaire and the spectacle independence questionnaire.

A total of 48 eyes (24 patients) were included in our study. 12 out of 24 subjects were randomized into the Vivity intervention group and 12 patients into the Symfony control group, all followed up for 3 months postoperatively. At 3-month follow-up, non-statistically significant differences in terms of UCVA were detected at distance (p=0.24), intermediate (p=0.91), and near (p=0.69). Likewise, there were no significant between-group differences regarding BCVA. During the observation period, halo size was larger with Tecnis Symfony® than with AcrySof® IQ Vivity®. Also, the intensity of the halo showed a lower perception in the Vivity group.

The two EDOF IOLs investigated provided similar clinical efficacy with a high degree of spectacle independence and patient satisfaction. In particular, there were no significant differences in the monocular distance, intermediate, near UCVA and BCVA among the two EDOF IOLs at 3-month follow-up. However, the AcrySof® IQ Vivity® provided lower subjective photic phenomena in terms of size and intensity of the halos than the Tecnis Symfony®.