Implantation Of A Enhanced Monofocal Edof Iol (Emv) As Rescue For Patients With Complaints Of Diffractive Trifocal Iol

To evaluate postoperative visual acuity (VA) and subjective quality assessment after mix-and-match implantation of an enhanced monofocal EDOF IOL (EMV) and a diffractive trifocal IOL versus bilateral implantation of trifocal lOL.

Retrospective cases review

The trifocal IOL was implanted in the first eye and the monofocal EDOF EMV IOL in the second eye if the patients complained about dysphotopsia symptoms. Otherwise, the second eye will also implant trifocal IOL. The postoperative analysis included VA at far, intermediate, and near distances, defocus curves, VF-7 questionnaire, wavefront analysis, and a halo and glare simulator.

Forty eyes of 20 subjects were collected. The bilateral trifocal IOL groups performed better at DCNVA (p<0.05) and at defocus levels of -1.75D to -4.0D (p<0.05), the mix-match with enhanced monofocal EDOF IOL group was better at -0.5D and -1.5D(p=0.013). Wavefront analysis disclosed lower HOAs in the trifocal group at 6 mm (p<0.05) and no difference (p = 0.33) at 3 mm pupil size. The monofocal EDOF IOL displayed increased positive SA at 6 mm pupil size. The UDVA and CDVA were btter in the EDOF group. Low rates of dysphotopsia phenomenon and satisfied results of the VF-7 questionnaire were obtained in the mix-match group after the second eye implantation (P=0.01).

Better visual quality and high satisfaction rates of VF-7 questionnaire were obtained after mix-and-match implantation of monofocal EDOF IOL and trifocal IOL. Enhanced monofocal EDOF IOL (EMV) could be an rescue alternative for 2nd eye to eliminate unhappy feeling for patients if the trifocal IOL in the first eye induced unwanted optical phenomena.