Combining Edof And Diffractive Iol – Clinical Results And Binocular Optical Performance

To study the binocular optical performance combining an EDOF IOL in the dominant eye and a diffractive trifocal IOL in the non-dominant eye.

Single surgeon Eye Clinic in Haugesund, Norway

Retrospective study of 50 subjects implanted with Alcon Vivity EDOF IOL in the dominant eye and Alcon PanOptix trifocal diffractive IOL in the non-dominant eye between March and November 2022.

All subjects had sequential, same day surgery and the indication for surgery was either refractive lens exchange (RLE) or cataract surgery. All subjects underwent a thorough clinical examination 3 months after surgery.

Primary endpoints were binocular optical performance such as visual acuity at distance, intermediate (60cm) and near (40 cm) and binocular defocus curve. Secondary endpoints were glass independence, satisfaction and subjective dysphotopsia  

Mean age at surgery was 58,4 ± 5.6. 55% were males and 45% females. Binocular UCDVA and BDCVA was log Mar -0.08 ± 0.04 and -0.11 ± 0.03. Binocular UDCIVA and BDCIVA was logMar 0.11 ± 0.12 and 0.05 ± 0.09. Binocular UCNVA and BDCNVA was logMar 0.09 ± 0.09 and 0.05 ± 0.06.

Binocular uncorrected and best distance corrected defocus curve showed visual acuity > 0.1 logMar between + 0.75 to – 3.25 Diopters. 85% reported complete glass independence performing daily activities, whereas 15% reported occasional need of glasses.

Subjective dysphotopsia such as haloes and glare were reported as mild or moderate in over 80% of subjects and the subjective satisfaction rate was equally high.  

The combination of an non-diffractive EDOF IOL in the dominant eye and a diffractive trifocal IOL in the non-dominant eye was very well accepted. The binocular unaided visual performance above logMar 0.1 showed a wide functional range with only mild dysphotopsia reported. Self reported QoV questionnaire indecated a high rate of satisfaction with this IOL combination and will be discussed in depth.

This initial report of such a combination looks very promising, but has to be studied more in detail in a prospective study.