Evaluation Of Visual Performance In Patients Implanted With A New Partial Range Of Field Enhanced Intraocular Lens

The enVista ASPIRE™ Toric (ETA) and enVista ASPIRE™ (EA) intraocular lenses (IOLs) are designed for primary implantation in the capsular bag of adult patients to correct aphakia following cataract extraction, with the toric model addressing pre-existing astigmatism. These hydrophobic acrylic monofocal IOLs provide an extended depth of focus (DOF) compared with standard monofocal lenses. This study aims to evaluate their visual performance, including visual acuity at different distances, defocus curve, and the presence of dysphotopsia, to assess the functional benefits of this new platform of enhanced monofocal IOLs.

This is a prospective, multicentre study of four surgeons from two study centres (Unidad de cirugía facorefractiva, Hospital Universitario Miguel Servet, Zaragoza, Spain, and Hospital Universitario Ramón y Cajal, Madrid, Spain) in patients presenting for cataract surgery.

This study evaluates the visual performance of  ETA and EA IOLs in patients with cataracts. Eligible patients had a normoreactive pupil and no prior ocular pathology or surgery. All procedures were femtosecond laser-assisted cataract surgeries (Victus, Bausch & Lomb, Inc) with APEX-centred implantation. Outcomes included refractive error best-corrected and uncorrected visual acuity at distance (BCDVA and UDVA) and intermediate (DCIVA and UIVA), and the defocus curve, with a 4–6 week follow-up after surgery. Refractive outcomes were compared with target values to assess the accuracy of these DOF IOLs.

A total of 90 eyes undergoing cataract surgery received the ETA (n=30) or EA (n=60) IOLs. Postoperative analysis of provisional results confirmed excellent distance and intermediate visual acuity, consistent with the advantages of enhanced monofocal IOLs over standard monofocals. Mean BCDVA was 20/20 or better, and DCIVA was 20/25 or better in more than 80% of eyes. The defocus curve demonstrated an extended range of functional vision, with a range of focus (ROF) exceeding 1.25D at a 0.2 logMAR cutoff, reflecting good intermediate performance. No significant dysphotopsias were reported, reinforcing the optical quality, predictability, and functional benefits of this advanced IOL platform.

In this study, the enVista ASPIRE™ IOLs, both toric and non-toric, provided high refractive accuracy and good visual acuity at distance and intermediate. These IOLs provide an extended DOF without compromising visual quality or inducing halos and glare, aligning with the characteristics of a partial-ROF enhanced IOL. This suggests these lenses can provide good functional vision across distance and intermediate distances while minimising dysphotopsia.