A Prospective Study Of The Bilateral Implantation Of An Extended Depth Of Focus Intraocular Lens In Patients Undergoing Phacoemulsification In One Eye And Phacovitrectomy For Epiretinal Membrane In The Fellow Eye.

Retinal disorders are a common contraindication for implantation of presbyopia-correcting intraocular lenses (IOL) due to the added loss of contrast sensitivity and the potential for induced dysphotopsia. However, new IOL designs like extended depth of focus (EDoF) IOL seem to induce minimal visual disturbances. We report the final results of a study evaluating the bilateral implantation of the AcrySof^® IQ Vivity^® EDoF IOL (Alcon, USA) in patients undergoing phacoemulsification in one eye and phacovitrectomy in the fellow eye for an epiretinal membrane (ERM).

OMIQ (Oftalmologia Mèdica i Quirúrgica) clinic in Barcelona, Spain.

We conducted a prospective, longitudinal study to evaluate the 6-month visual outcomes in patients with bilateral cataracts and unilateral grade 2 or 3 ERM undergoing phacoemulsification in one eye and phacovitrectomy in the fellow eye with implantation of the AcrySof^® IQ Vivity^® EDoF IOL. Patients with other ocular comorbidities in either eye were excluded. The endpoints included monocular and binocular distance, intermediate and near corrected and uncorrected logMAR visual acuities (VA), contrast sensitivity (CS, Pelli-Robson), low contrast (25%) VA at 66 and 40 cm, and quantification of dysphotopsias (Light-distorsion analyzer^®, CEORLab).

The final results included 22 patients, 50% were female and the mean (standard deviation) age was 71.4 (5.8) years. There were no differences in baseline features between eyes, except for those related to retinal thickness and volume. Uncorrected and distance-corrected binocular VA were 0.03 (0.13) and -0.01 (0.07, distance), 0.10 (0.08) and 0.10 (0.08, intermediate), and 0.28 (0.15) and 0.30 (0.15, near), respectively. Binocular CS was 1.64 (0.06), low contrast VA at 66 cm was 0.57 (0.14) and at 40 cm it was 0.66 (0.16). Light distorsion index was 13.81% (15.88). Also, all measurements were similar between ERM and non-ERM eyes except for near VA.

The binocular functional results after the bilateral implantation of the AcrySof^® IQ Vivity^® EDoF IOL in patients undergoing cataract surgery in one eye and phacovitrectomy in the fellow eye due to ERM were excellent. Additionally, the visual results in the vitrectomized and the non-vitrectomized eyes were similar in all measurements except for near VA. Therefore, these IOL can be an option for selected patients with ERM who wish to gain spectacle independence after surgery.