Comparison Of Tolerance To Induced Astigmatism In Pseudophakic Eyes Implanted With Hybrid Multifocal And New Monofocal Intraocular Lenses.

To compare the effect of induced astigmatic and defocus conditions on visual performance in patients with a dominant eye implanted with either a new monofocal intraocular lens (IOL) with extended-depth-of-focus (EDOF) characteristics or a hybrid multifocal IOL.

Department of cataract, Hospital Oftalmológico de Brasília, Brasília, Distrito Federal, Brazil.

This non-randomized cohort study divided into two groups.  Group 1 consisted of 12 patients who underwent small-incision cataract extraction and received the Tecnis Synergy ZFR00V IOL (Johnson&Johnson) in their dominant eye. Group 2 included 12 patients who had the Tecnis Eyhance ICB00 IOL (Johnson&Johnson) implanted in their dominant eye. All patients had residual astigmatism less than 0.50 diopters and no ocular disease. After 16 weeks, the astigmatic tolerance was evaluated by measuring monocular distance visual acuity using negative cylindrical (CYL) lenses of varying powers (0.00 to 2.00 diopters in 0.50 increments on 90° and 180° axis) on a defocus curve (-3.00 to +2.00 diopters in 0.25 increments).

The study found that there were no significant differences in visual outcomes between the groups when comparing induced astigmatism with no defocus condition. However, when the axis of astigmatism was considered, there was a statistically significant difference between 90° and 180° with 1.50D CYL in group 1. The study showed that visual acuity was better when the astigmatism was 1.50D CYL at 90° than at 180° axis (p<0.05). Additionally, group 1 performed better than group 2 at 0.50 and 1.50 CYL at 90° axis with -1.00D defocus condition (p<0.05). 

The type of IOL used can affect visual outcomes when astigmatism is present. The Tecnis Synergy ZFR00V IOL performed better than the Tecnis Eyhance ICB00 IOL when comparing induced astigmatism with defocus conditions, specifically at 0.50 and 1.50 CYL at 90° axis with a -1.00D defocus condition. The study also found that visual acuity was better in the Tecnis Synergy ZFR00V group when the astigmatism was 1.50D CYL at 90° compared to 180° axis.