Clinical Outcomes Of Presbyopia-Correcting Implantable Collamer Lenses In Early Presbyopia And Patient Satisfaction With A Mix-And-Match Strategy

To evaluate clinical outcomes of an extended depth-of-focus implantable collamer lens (EDOF ICL) in patients with early presbyopia and to compare patient-reported satisfaction between bilateral implantation and a mix-and-match strategy.

Retrospective comparative chart review, Single refractive surgery center in the Republic of Korea.

Patients aged 40 years or older with myopia and mild to moderate presbyopia who underwent EDOF ICL implantation in at least one eye were included. In mix-and-match cases, the fellow eye implanted with a monofocal ICL was also analyzed. Visual, refractive, and satisfaction outcomes were evaluated at 6 months postoperatively. Satisfaction was compared between bilateral EDOF ICL implantation and mix-and-match implantation with one EDOF ICL and one monofocal ICL.

A total of 102 eyes (75 EDOF ICL eyes) from 51 patients were analyzed. Refractive accuracy was comparable between EDOF ICL and monofocal ICL eyes. Distance visual acuity was significantly better in monofocal ICL eyes, whereas near visual acuity tended to be better in EDOF ICL eyes without statistical significance. Satisfaction analysis included 38 patients, including 18 with bilateral EDOF ICL implantation. Near and intermediate vision satisfaction was similar between groups. Dysphotopsia was more frequent after bilateral EDOF ICL implantation but did not reach statistical significance (P = 0.06). Overall satisfaction was higher in the mix-and-match group (P = 0.048).

EDOF ICL implantation provided acceptable short-term outcomes in early presbyopia. Bilateral implantation was associated with increased dysphotopsia and slightly inferior distance vision. A mix-and-match strategy may improve overall satisfaction.