Investigating Visual Performance: A Comparison Of Extended Depth-Of-Focus Intraocular Lenses And Spherical Monofocal Intraocular Lenses

Presbyopia-correcting IOLs, including multifocal IOLs (MFIOLs) and extended depth-of-focus (EDOF) IOLs, are effective for treating presbyopia. Unlike MFIOLs, EDOF IOLs offer a smooth focal length, improving vision range. However, near-visual acuity is a significant concern with current EDOF IOLs, highlighting the need for improved designs that enhance near vision while maintaining distance quality. Strategies for designing EDOF IOLs include increasing spherical aberration. A clinical trial was conducted to compare the visual performance of a commercial EDOF IOL with a spherical monofocal IOL.

Clinical trial

This study involved two groups, one using an EDOF IOL and the other a spherical monofocal IOL. We assessed visual acuity across three ranges, conducted auto-refraction, examined the defocus curve, and tested contrast sensitivity. Additionally, we gathered patient-reported outcomes (PROs) covering near visual quality, quality of life, spectacle independence, and dysphotopsia at the same time.

A total of 12 patients participated in this study. One month after surgery, visual performance was similar between the EDOF and monofocal IOL groups, although uncorrected intermediate visual acuity was significantly better in the monofocal IOL group. However, in the three months following surgery, intermediate visual acuity improved more in the EDOF group compared to the monofocal IOL group. The defocus curve supported these findings. Regarding contrast sensitivity, results for the EDOF group were comparable to the monofocal group, indicating that dysphotopsia was subjectively acceptable among our EDOF participants. Additionally, satisfaction with near visual quality and independence from spectacles was higher among the EDOF group.

After sufficient adaptation, near vision improved more in the EDOF group than in the monofocal group. Nonetheless, the spherical monofocal group also demonstrated some near vision, suggesting that increased spherical aberration may enhance near vision. Longer durations and a larger patient cohort are necessary to more conclusively verify the differences between these groups. The results from the post-operative assessment could serve as a basis for developing a new EDOF type.