Clinical And Functional Outcomes Of A Non-Diffractive Edof Intraocular Lens Based On An Advanced Hydrophobic Acrylic Platform

To evaluate the visual performance, functional defocus range, contrast sensitivity, and patient-reported outcomes following implantation of the Clareon® Vivity® non-diffractive extended depth-of-focus intraocular lens (Alcon Laboratories, Inc., Fort Worth, TX, USA), and to assess its ability to provide extended depth of focus while maintaining contrast sensitivity and high patient satisfaction.

The study included 5 patients (10 eyes) with a mean age of 62.2 years (range 53–73); three were male and two female. Mean IOL power was 20.8 ± 1.9 D (range 17.5–24.0 D). Preoperative mean higher-order aberrations (HOA) were 0.18 ± 0.05 µm, with a mean Z4,0 spherical aberration of 0.31 ± 0.09 µm. Mean pupil diameter measured with Pentacam was 3.86 ± 1.05 mm, and mean axial length was 24.55 ± 1.78 mm, representing a predominantly normal axial length population.

This retrospective consecutive case series included patients undergoing femtosecond laser–assisted cataract surgery (FLACS), all procedures performed by the same surgeon (EDR). Biometry was obtained using the IOLMaster 700, and IOL power was calculated with the ESCRS online IOL calculator. Corneal topography was performed using Pentacam. Postoperative evaluation included monocular and binocular visual acuity, defocus curve, contrast sensitivity (photopic and mesopic), and VFQ-14. Statistical analysis was performed using SPSS software. Due to the small sample size, non-parametric comparisons were conducted using the Mann–Whitney U test.

Mean uncorrected distance visual acuity (UDVA) was 0.01±0.05 logMAR, uncorrected intermediate visual acuity (UIVA, 0.65 m) 0.05±0.17, and uncorrected near visual acuity (UNVA, 0.35 m) 0.23±0.18. Mean corrected distance visual acuity (CDVA) was −0.01±0.05 logMAR. Postoperative spherical equivalent was −0.03±0.36 D with residual cylinder −0.34±0.30 D. Monocular defocus peaked at plano (−0.01 logMAR), providing 2.0 D at ≤0.20 and 3.0 D at ≤0.30 logMAR. Binocular peak reached −0.02 logMAR, extending the ≤0.30 range to 3.5 D. Contrast sensitivity was preserved at low–intermediate frequencies. VFQ-14 showed minimal limitation; 100% would choose the same IOL again.

1. Clareon Vivity provided a continuous 2.0 D functional range at ≤0.20 logMAR and up to 3.5 D binocularly at ≤0.30 logMAR, demonstrating extended depth performance.

2. Binocular summation enhanced the functional range by 0.5 D compared with monocular outcomes.

3. Contrast sensitivity was preserved at low and intermediate spatial frequencies under both photopic and mesopic conditions, with no disproportionate high-frequency loss.

4. Patient-reported outcomes showed minimal visual limitation, high satisfaction for distance and intermediate vision, and 100% willingness to undergo the same procedure again.