Visual Performance Of An Extended Depth Of Focus Intraocular Lens In Eyes With Low To Moderate Irregular Astigmatism

To test monocular and binocular far and intermediate vision in patients with low to moderate irregular astigmatism receiving an enhanced depth of focus (EDOF) intraocular lens (IOL).

Single center, prospective, clinical trial 

Patients with irregular astigmatism exhibiting an anterior root mean square (RMS/a) of 0.3μm/mm2 or higher in the 3.0 mm zone in at least one eye were included in the study. Irregular astigmatism was measured using an anterior segment OCT MS-39 (CSO, Firenze, Italy). All patients received either a monofocal Acrysof Vivity DFT015 or toric DFT215-615 IOL if the total astigmatism was more than 0.75 diopters (D). Monocular and binocular best-corrected distance visual acuity (BCDVA), monocular distance-corrected intermediate visual acuity (DCIVA) at 66cm and monocular distance-corrected near visual acuity (DCNVA) at 40cm were assessed using ETDRS charts at 4 months (4m). Monocular defocus curves were assessed at 4m.

Twenty-three patients including 46 eyes were included in the study. Mean preoperative RMS/a was

0.037±0.012μm/mm2. Monocular BCDVA at 4m for the study eye was -0.03±-0.05 logMAR. Binocular BCDVA was - 0.07±0.09 logMAR. Monocular DCIVA was 0.18±0.1 logMAR. Monocular DCNVA was 0.38±0.1 logMAR.

Patients with low to moderate irregular astigmatism showed very good postoperative monocular distance visual acuity below 0.0 logMAR. Binocular distance corrected visual acuity was even better with -0.07 logMAR. Low to irregular astigmatism is no exclusion criteria for binocular implantation of an EDOF IOL.