Effectiveness Of Extended Depth Of Focus (Edof) Compared To Trifocal, Bifocal And Accommodative Intraocular Lenses (Iol) To Correct Presbyopia After Cataract Surgery
Published 2024 - 42nd Congress of the ESCRS
Reference: FP21.01 | Type: Free paper | DOI: 10.82333/2jpm-fk20
Authors: Christin C E Henein* 1 , Qëndresë Daka 2 , Clarissa E.H. Fang 3 , Desta Bokre 1 , Rona Mustafa 2 , Ergon Çoçaj 2 , Augusto Azuara-Blanco 4 , Colin Willoughby 5 , Mayank Nanavaty 6
1Institute of Ophthalmology ,UCL,London,United Kingdom, 2University of Prishtina,Prishtina,Kosovo, 3Manchester Royal Eye Hospital,Manchester,United Kingdom, 4Queen's University,Belfast,United Kingdom, 5Ulster University,Londonderry,United Kingdom, 6Sussex Eye Hospital,Brighton,United Kingdom
Purpose
Cataract extraction is the most prevalent ocular surgery performed globally. In developed countries, this procedure frequently aims to minimize the need for glasses, aligning with the increasing patient demand for spectacle-free near and intermediate vision, which is essential for daily tasks, in addition to excellent distance vision. Extended Depth of Focus (EDOF) intraocular lenses operate by creating a prolonged focal point to broaden the visual range; these can include diffractive or non-diffractive elements to achieve this effect. However, the evaluation of these optical properties in a laboratory setting does not always align with clinical outcomes regarding patient satisfaction and the actual achievement of spectacle independence.
Setting
In this ESCRS funded systematic review project we performed an overview of systematic reviews of RCTs and to summarize data on the performance of extended depth of focus (EDOF) compared to trifocal, bifocal and accommodative intraocular lenses (IOL) to correct presbyopia for cataract surgery.
Methods
Ovid MEDLINE, Ovid EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus were searched for the reviews published in the last 10 years that assessed IOL types according to the PICO parameters: (P)Adults ≥ 40 years of age who underwent phacoemulsification with IOL implantation, (I, C) extended depth of focus (EDOF) (diffractive and non-diffractive), trifocals, bifocals and accommodative IOLs, (O) binocular uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA), near visual acuity (UNVA), and spectacle independence (SI). Evaluation of the systematic review methodology was done using AMSTAR-2 tool. Study raw data were extracted, complied into tables, and synthesized.
Results
Extended depth of focus (EDOF) IOLs vs. trifocal diffractive UDVA MD: - 0.01 [95% CI: − 0.03, 0.05], UIVA MD: -0.03 [95% CI: − 0.29, 0.23], UNVA MD: 0.08 [95% CI: -0.06, 0.21] and SI RR: 1.65 (0.24, 11.14); EDOF vs. bifocal refractive UDVA MD: -0.05 [95% CI: -0.07 , -0.02], UNVA MD: -0.02 [95% CI: -0.06 , 0.03] and SI RR: 2.52 [95% CI: 1.90 to 3.36] ; EDOF vs bifocal diffractive UDVA MD: -0.05 [95% CI: -0.08 , -0.03] , UIVA MD: -0.11 [95% CI: −0.14 to -0.08], UNVA MD: 0.10 [95% CI: 0.06 , 0.14] and SI RR: 1.16 [95% CI: 0.92 to 1.47] ; EDOF vs accommodative UDVA MD: 0.00 [95% CI: − 0.06 to 0.06], UIVA MD: 0.53 [95% CI: -5.75 to 6.80],UNVA MD: -0.08 [95% CI: − 0.38 to 0.25] and SI RR: 2.66 [95% CI: 0.05 to 94.48].
Conclusions
UDVA favoured EDOF when compared to bifocal refractive and bifocal diffractive IOLs. There was no statistical difference between EDOF and trifocal diffractive IOL for UDVA or UIVA or SI. UIVA favoured EDOF when compared to bifocal diffractive. UNVA favoured trifocal diffractive and bifocal diffractive when compared to EDOF. Spectacle independence favoured bifocal refractive IOLs compared to EDOFs. There was no statistical difference between EDOF and accommodative IOLs across all measured outcomes.