Clinical Evaluation Of The Multifocal Performance Of An Edof Iol Implanted Bilaterally Using The Mini-Monovision Method And Assessed With The Multifocal Lens Analyzer Application

This study aimed to evaluate the multifocal performance in patients following cataract surgery with bilateral implantation of the Bausch & Lomb LuxSmart™ Extended Depth of Focus (EDOF) intraocular lens (IOL) using the mini-monovision method. A commercially available tablet-based application was used for assessment. To ensure an accurate evaluation of the real world visual acuity, all measurements were performed without spectacle correction. Patients were assessed one month after the implantation of the second IOL.

All surgeries were performed at a private hospital setting in Athens, Greece, by a single experienced surgeon. Eligibility for EDOF IOL implantation was determined during the preoperative assessment, considering each patient’s daily visual requirements and lifestyle. Only patients with no ocular pathologies were included.

Twenty patients underwent sequential bilateral, uncomplicated femtosecond laser-assisted cataract surgery with implantation of the B&L LuxSmart™ EDOF IOL. The mini-monovision technique was applied, targeting a refraction of +0.00 D (dominant eye) and -0.50 D (non-dominant) eye. The defocus curve was assessed using the Multifocal Lens Analyzer App v.3.0, with 0.5 D increments from +1.50 D to -3.50 D on an Apple iPad. All assessments were performed under standardized conditions. The iPad was positioned 2 meters in front of the refractor, as per the application’s instructions. The Tumbling E eye chart within the app was used. Patients had 10 seconds to respond per test item. A separate timer recorded the total examination duration.

All patients were satisfied with their visual outcomes, achieving LogMAR 0 for distance vision with minimal standard deviation (SD ±0.01). Intermediate vision was also highly satisfactory, with a mean LogMAR 0.04 (SD ±0.05). Near vision demonstrated a mean LogMAR of 0.19 (SD ±0.14), with all patients reporting the ability to read without near-vision spectacles. The mean examination time was 4 minutes 34 seconds (SD ±27 seconds). All patients were within 0.50 D of the targeted refraction postoperatively.

Integrating novel technologies into routine clinical practice enhances our understanding of patients’ real-world visual performance following EDOF IOL implantation with mini-monovision. The Multifocal Lens Analyzer proved to be an efficient and user-friendly tool for both patients and examiners, offering valuable insights into cases of patient dissatisfaction. Based on this study, bilateral implantation of the B&L LuxSmart™ IOL using mini-monovision (with a non-dominant eye target refraction of -0.50 D) is an effective method for achieving spectacle independence.