Visual Performance And Optical Quality With A Non-Diffractive Biaspheric Extended Depth Of Focus Intraocular Lens: Defocus Curve And Objective Scatter Index Analysis

To evaluate the monocular defocus curve and objective scatter index (OSI) outcomes in patients who underwent bilateral implantation of a biaspheric non-diffractive enhanced depth of focus (EDOF) intraocular lens (Asqelio EDOF, AST VisionCare Inc, USA) 3 months postoperatively

Magrabi Eye Hospitals, Jeddah, KSA

Thirty-four patients (68 eyes) underwent bilateral sequential phacoemulsification with non-diffractive EDOF IOL, targeting emmetropia in dominant eyes and -0.50 D in fellow eyes. Indication for surgery was refractive lens exchange (RLE) in 53% and cataract in 47% eyes . Exclusion criteria included previous ocular surgery, corneal higher order aberrations >0.6 µm, corneal astigmatism >1.50 D, and OSI >3.50. At 3 months, monocular distance-corrected defocus curves were measured under photopic conditions. OSI was assessed with HD Analyzer (Visiometrics SL, Barcelona, Spain); modulation transfer function (MTF), Strehl ratio and visual Strehl optical transfer function (VSOTF) were measured with iTrace device (Tracey Technologies Inc, TX, USA).

Monocular defocus curves showed visual acuity better than 0.20 logMAR over a range from +1.00 D to -1.50 D. Mean OSI decreased significantly in cataract eyes (2.37 ± 0.79 to 1.40 ± 0.49; p<0.001) and increased in RLE eyes (0.74 ± 0.26 to 1.29 ± 0.55; p<0.001). MTF average height, PSF Strehl ratio, and VSOTF did not show significant differences. Most patients reported no need for glasses at far or intermediate distances with good functional uncorrected near visual acuity. Subjective questionnaires showed high satisfaction and minimal photic disturbances.

Bilateral implantation of a non-diffractive EDOF IOL yielded a continuous range of good visual acuity for distance and intermediate tasks, with functional near vision. Scatter improved significantly in cataract eyes and increased in RLE eyes without affecting overall satisfaction. These findings suggest that non-diffractive EDOF IOLs provide favorable optical quality with minimal photic phenomena and high patient satisfaction at 3 months after surgery.