Clinical Outcomes In Eyes With Diffractive Extended Depth Of Focus Intraocular Lenses Enhanced For Near Vision: Comparison With Trifocal Intraocular Lenses

To prospectively assess the visual performance of eyes after bilateral implantation of diffractive extended depth-of-focus intraocular lenses (IOLs) enhanced for near vision Synergy (J&J), compared with trifocal IOLs.

Three clinic sites in Japan.

This investigator-initiated study was approved by a local Certified Review Board (registered: jRCTs032210305). Synergy IOLs (group S) and trifocal IOL (AcrySof PanOptix, Alcon, group P) were bilaterally implanted in 30 patients each. Three months postoperatively, binocular outcomes of uncorrected (BUCVA) and distance-corrected (BDCVA) visual acuities at distances of 0.3, 0.4, 0.5, 0.7, and 5 m. Contrast sensitivities were binocularly measured using CSV-1000 (4 m) and Pelli-Robson charts at distances of 0.4 and 1 m. Symptoms of glare, halo, starburst and waxy vision, and satisfaction for near, intermediate and far visions were assessed with questionary. Differences between two groups were examined.

Twenty-seven patients each completed the follow-up, and the mean age of the group S was younger (P <0.001). The mean BUCVA at 0.4 m was better in the group S, whole the mean manifest refraction of the group P was significantly hyperopic shifted (P < 0.001). In the mean BDCVA, there was a significantly better in the group S. In contrast sensitivity results at three distances, no difference was found. Although more patients in the group S reported significant glare and halo, satisfaction of near vision was higher.

Binocular visual functions of the patients with Synergy IOLs were comparable or better that the patients with the trifocal IOLs. While glare and halo were enhanced, patient satisfied near vision. Understanding of the differences between two types of presbyopia correcting IOLs would be important to accommodate the patient satisfaction.