Clinical Outcomes And Patient Satisfaction Of A Cost-Conscious Mix-And-Match Extended Depth Of Focus Intraocular Lens Strategy In Bilateral Cataract Surgery: A Retrospective Study At Southern Quang Tri Eye Hospital

The purpose of the study is to evaluate visual acuity outcomes, refractive predictability, spectacle independence, and patient-reported satisfaction following bilateral cataract surgery using a mix-and-match EDOF IOL strategy in patients with partial insurance coverage for premium multifocal IOLs.

This retrospective observational study included 31 consecutive patients (62 eyes) who underwent planned bilateral phacoemulsification with EDOF IOL implantation between October 2024 and December 2025 at Southern Quang Tri Eye Hospital. 

This is a retrospective observational study. The dominant eye was targeted for emmetropia, and the non-dominant eye for mild myopia (–0.50 to –0.75 diopters) to achieve mini-monovision. Preoperative evaluation comprised uncorrected and corrected distance visual acuity (UDVA, CDVA), manifest refraction, and optical biometry. Postoperative assessments at 1, 3, and 6 months included binocular UDVA, uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), manifest refraction spherical equivalent (MRSE), contrast sensitivity testing, spectacle independence rates, and patient-reported visual disturbances. Statistical analysis compared preoperative and postoperative parameters, with significance set at p < 0.05.

At 3 months of follow-up, binocular visual acuity demonstrated statistically significant improvement compared with baseline (p<0.05). Binocular UDVA of 20/25 or better was achieved in 90.3% of patients, UIVA of 20/30 or better in 87.1%, UNVA of Jaeger J3 or better in 74.2%. Postoperative MRSE was within ±0.50D in 85.5% of eyes, reflecting high refractive accuracy. Spectacle independence was reported by 93.5% of patients for distance, 90.3% for intermediate, and 80.6% for near activities. Mild to moderate dysphotopsia (glare or halos) occurred in 16.1% of patients but did not significantly compromise overall satisfaction or daily functioning. No intraoperative complications or vision-threatening postoperative adverse events were observed.

In a partially reimbursed healthcare setting, a mix-and-match EDOF IOL strategy incorporating mini-monovision provided excellent binocular visual outcomes, high refractive predictability, and substantial spectacle independence with minimal photic phenomena. This approach represents a safe, clinically effective, and economically rational alternative to premium multifocal IOL implantation for patients seeking enhanced postoperative visual performance.