Extended Depth Of Focus Iol After Phacoemulsification In Mild Maculopathy - A Prospective Study

to evaluate improvement and quality of vision after implantation of Extended Depth Of Focus (EDOF) IOL following phacoemulsification in both eyes with bilateral mild maculopathy.

Mild maculopathy may cause permanent, progressive loss of central vision. Cataract development in eyes with maculopathy may further decrease quality of vision. A prospective study was done in patients having bilateral mild maculopathy of various etiology with cataract and underwent uncomplicated phacoemulsification with EDOF IOL implantation in both eyes.

42 eyes(21 pts) were studied.Period:Mar,2025 to Nov,2025.After uncomplicated phacoemulsification EDOF IOL was implanted in both eyes at 1 mo interval.Included: mild maculopathy in both eyes,initial VA 6/12-6/9,cataract grade NS 3 or NS 4, ci DME-10,non-centre involving DME- 10,early AMD-14,ERM-6,BRVO-2 eyes.No history of anti‑VEGF,laser,operation in 3 mo & no ocular surface disease.Excluded:geographic atrophy,advanced DME,macular hole.Initial & follow up Best corrected visual acuity(BCVA),contrast sensitivity,post-op fixation, glare & halo assessment were done.SS OCT was done for macular thickness,photoreceptor integrity,subretinal fluid,staging of ERM.IOL simulation(trial lenses) & pt counselling were done. Post-op assessments-at 3 & 6 mo.

42 eyes(21 pts).M=10,F=11.Mean age:M=66.3,F=60.1 yrs.In 3 eyes macular edema increased after phaco(excluded).Pre-op VA range-6/12 to 6/60.Defocus curve:functional range of vision between + 0.50D & -1.50D,post-op mean VA maintained between 6/9-6/12.Distant VA- 83% eyes achieved ≥6/9 & 92.9% achieved ≥6/12.Paired comparison of Pelli-Robson contrast sensitivity test showed a significant improvement-1.28 ± 0.15 logCS(pre-op) to 1.35 ± 0.14logCS at 3 mo after phaco.Mean improvement 0.07log CS(p=0.002).Post-op in 39 eyes,no significant macular changes on ss OCT.All eyes showed steady, central & maintained fixation.Pt reported outcome- 51.3% were very satisfied,35.9% were satisfied with post-op VA. Mild glare in 23.1%. No photic symptoms in 64.1%.

in this prospective study of 39 eyes(3 eyes excluded) in 21 patients, bilateral implantation of an EDOF intraocular lens following phacoemulsification in eyes with mild maculopathy showed improved visual and functional outcomes. All patients achieved satisfactory distance, intermediate vision with good visual acuity and reasonable dysphotopsia. Careful patient selection with mild maculopathy can benefit from EDOF IOL implantation without significant compromise in quality of vision. EDOF IOL may be an viable alternative for visual rehabilitation in patients with mild maculopathy undergoing phacoemulsification surgery. Larger studies with longer follow up are necessary for further validation.