Visual Outcomes Following Implantation Of A Novel Non-Diffractive Wavefront-Linking Extended Depth Of Focus Intraocular Lens

To evaluate the clinical outcomes following bilateral implantation of the Bi-Flex ELON intraocular lens(IOL) which utilises a series of central concentric refractive zones with varying curvatures to extend the depth of focus.

LEC Eye Centre, Ipoh, Malaysia

Prospective interventional case series of patients with bilateral significant cataracts  undergoing cataract surgery and implantation of ELON. Dominant eyes were targeted at emmetropia and non-dominant eyes at -0.75D. Primary endpoints were binocular uncorrected distance(UDVA), intermediate(UIVA at 66cm) and near(UNVA at 40cm) acuities at 3 months. Secondary outcomes were best corrected distance(CDVA), distance corrected intermediate (DCIVA) and distance corrected near(DCNVA) acuities as well as refractive predictability,  binocular defocus curve, contrast sensitivity, Patient Reported Spectacle Independence(PRSIQ), Dysphotopsia and VF-14 questionnaire scores.

15 patients(30 eyes) underwent uneventful phacoemulsification by a single surgeon and the outcomes at 3 months are reported. The mean binocular logMAR UDVA, UIVA and UNVA were 0.06+0.10, 0.13+0.09 and 0.22+0.15 respectively. The mean binocular logMAR CDVA, DCIVA and DCNVA were 0.02+0.06, 0.14+0.14 and 0.31+0.20 respectively. The mean refractive spherical equivalent(MRSE) was -0.04+0.48 with all eyes within 1D of target refraction. None of the patients needed glasses for distant and intermediate vision and 5 patients required spectacles for reading some of the time. The mean VF-14 score was 94.75(maximum score is 100) and 9 patients reported dysphotopsias but only 1 was significantly bothered by them.

Patients with bilateral implantation of the ELON IOL showed excellent binocular distant and intermediate vision with very good functional near vision. High levels of spectacle independence was achieved and majority of patients were not bothered by dysphotopsias.