Evaluation Of Visual Outcomes And Tolerance After Bilateral Implantation Of An Extended Depth Of Focus Intraocular Lens In Patient Suffering From Cataract And Mild Keratoconus.

To evaluate visual outcomes and satisfaction after bilateral implantation of the non diffractive extended depth of focus intraocular lens Acrysof Iq Vivity in patients suffering from cataract and mild keratoconus

Ophthalmology Clinic, Department of Surgery, Dentistry, Maternity and Infant, University of Verona, Verona, Italy

This pilot study included 10 patients affected by cataract and mild keratoconus (stage A0B1 or stage A1B1 or A1B2) evaluated with MS-39 anterior segment OCT (CSO, Florence, Italy). The patients were bilaterally implanted with the EDOF IOL Acrysof Vivity (targetting bilaterally to emmetropia). Three months follow-up included: mean refractive spherical equivalent (MRSE), binocular distance corrected and uncorrected visual acuity at 4m (DCVA and UDVA), 80cm (DCI80VA and UI80VA), 66 cm (DCI66VA and UI66VA) and 40cm (DCNVA and UNVA), binocular defocus curves, contrast sensitivity (CS), subjective and objective (Root mean square-RMS, point-spread-function -PSF- Strehl ratio) visual quality, and the NEI RQL 42 questionnaire was administred.

Seven females and 3 males with a mean axial lenght of 24.19±1.36 mm received the EDOF IOL with a mean spherical power of 17.97D±3.8 and a mean cylindrical correction of 1.75 D±0.85. MRSE was -0.62. Binocular UDVA, UI80VA, UI66VA and UNVA were 0.11±0.10, 0.13±0.13, 0.15±0.13 and 0.36±0.10 logMAR, respectively. The binocular DCVA, DCI80VA, DCI66VA, DCNVA were 0.05±0.08 (p=0.23), 0.06±0.06 ,0.08±0.10 and 0.2±0.15 (p>0.05). All mean visual acuities at defocus curves were lower than 0.2 logMAR between +0.50 D and -2.00 D. CS were higher binocularly. Mean RMS and PSF Strehl ratio were 0.70±0.54 and 0,.3±0.13, respectively. Subjectively, patients were more satisfied for near vision than far one and did not complain activity limitations.

In this study the EDOF IOL allowed satisfactory visual outcomes with no statistical significant difference between UDVA and DCVA nor UNVA and DCNVA, enabling all patients to perform their daily activities without limitations. All patients declared better performance from near than from far away, probably favored both by a slightly negative MRSE but also by the presence of keratoconus The presence of early and mild keratoconus does not appear to be a major contraindication to the implantation of the Acrysof Vivity EDOF IOL