Tolerance To Induced Astigmatism Amongst Various Intraocular Lenses Categories

To compare tolerance to induced astigmatism (TIA) in eyes implanted with one of four types of intraocular lens (IOL) - standard monofocal, enhanced monofocal, and new generation diffractive extended depth-of-focus (EDOF), and diffractive multifocal.

 Medical University of South Carolina (MUSC), Storm Eye Institute (SEI), South Carolina

This prospective, observational study enrolled patients who underwent cataract surgery with implantation of either a standard monofocal (ZCB00, n=20, group 1), enhanced monofocal (DIB00, n=20, group 2), diffractive EDOF (ZXR00V, n=30, group 3) or diffractive multifocal (DRN00V, n=21, group 4) IOL, from the same manufacturer (J&J Vision). Astigmatic defocus was tested with induced astigmatism up to 2.0 diopters in orientations of against-the-rule (ATR), oblique and with-the-rule (WTR) 1-3 months postoperatively.

The 4 groups had no statistically significant differences in uncorrected-distance and distance-corrected visual acuities. Distance-corrected near and intermediate visual acuities were better in group 4 than other groups (p<0.001). Median astigmatic defocus to maintain visual acuity within one-line reduction was 1.0D in WTR orientation, and less in oblique and ATR astigmatism for all groups. There were no statistically significant differences amongst the 4 groups for WTR astigmatism up to 2.0D. For 2.0D oblique astigmatism, group 2 performed one line better than other groups. For 1.5D ATR, groups 2 and 4 were one line better than groups 1 and 3 (p<0.001). For 2.0D ATR, group 2 was one line better than all other groups (p=0.005).

Tolerance to induced astigmatism was nonsignificant amongst the 4 groups for WTR astigmatism up to 2.0D. Induced oblique and ATR astigmatism were better tolerated in the enhanced monofocal IOL group compared to the standard monofocal, EDOF and multifocal IOL groups. Overall, WTR astigmatism was better tolerated than oblique and ATR in all groups.