Assessment Of Different Extended Depth Of Focus Intraocular Lens Technologies: A Comparative Analysis About 108 Patients
Published 2024 - 42nd Congress of the ESCRS
Reference: FP29.01 | Type: Free paper | DOI: 10.82333/nkwh-ff65
Authors: Roman Chudzinski* 1 , Emilie Agard 2 , ANTOINE LEVRON 2 , IKRAME DOUMA 2 , JEREMY BILLANT 1 , PHILIPPINE COTTE 1 , Pierre LEROUX 1 , Corine DOT 3
1CHU E. Herriot ,HOSPICES CIVILS DE LYON,Lyon,France, 2HIA Desgenettes,Lyon,France, 3CHU E. Herriot ,HOSPICES CIVILS DE LYON,Lyon,France;Academy of val de Grâce,Paris,France
Purpose
This study aims to compare refractive outcomes, spectacle independence, and adverse effects in patients undergoing bilateral cataract surgery with extended depth of focus (EDOF) implants. Four implants are compared: a non-diffractive EDOF (NDEDOF; Alcon® Acrysof Vivity), a refractive EDOF (REDOF; LENTIS® Comfort), a diffractive EDOF (DEDOF; Zeiss® AT LARA), and a monofocal implant as a comparator (MonoF; Alcon®, Clareon). Additionally, we investigated as a secondary outcome the influence of high-order aberrations (HOA) on visual acuity.
Setting
The study was conducted at a single ophthalmology center, involving 108 patients who underwent cataract surgery with bilateral implantation of EDOF IOLs or a monofocal IOL.
Methods
Patients eligible for a premium EDOF IOL were assigned to one of the implants per period. Uncorrected and corrected distance, intermediate, and near visual acuity were assessed at three months. The occurrence of photic phenomena and spectacle independence were evaluated using a modified McAliden questionnaire. Preoperative high order aberrations were also measured.
Results
One hundred percent of patients achieved 20/20 vision with correction with the Monofocal,REDOF and NDEDOF implants, compared to 96% DEDOF implants respectively (p>0.05). All EDOFs showed a significant improvement in intermediate and near vision versus monofocal IOL (p<0,001). Photic effects were absent or mild (score <4/27) for 75% of NDEDOF, 78% of REDOF, 66% of DEDOF, and 91% of MonoF. The DEDOF group reported significantly more photic effects, with a mean score of 3.5/27 (p<0.05). In terms of spectacle independence, EDOFs showed a superiority versus the MonoF without differences between them, An important independence is reported in at least 36% of patients The impact of preoperative corneal HOA on visual outcomes in under process.
Conclusions
The three analyzed EDOF implants do not impact the distance visual acuity compared to MonoF while they significantly increase the intermediate and near vision. Total to subtotal independence from glasses is achieved in half of EDOF patients, slightly favoring diffractive EDOF. However, the diffractive EDOF implant causes more photic effects, despite no severe photic effects were reported with these three technologies.