Visual Outcomes Following Bilateral Implantation Of A Rotationally Asymmetric C-Loop Hydrophobic Extended Depth Of Focus Intraocular Lens

To evaluate visual and patient-reported outcomes following bilateral implantation of the Acunex Vario extended depth of focus (EDOF) intraocular lens (IOL).

LEC Eye Centre, Ipoh, Malaysia

Prospective interventional case series of patients with bilateral cataracts undergoing phacoemulsification and implantation of the Acunex Vario. Dominant eyes were targeted for emmetropia and non-dominant eyes for −0.75 D. Primary endpoints were binocular uncorrected distance (UDVA), intermediate (UIVA, 66 cm) and near (UNVA, 40 cm) visual acuities at 3 months. Secondary outcomes included best-corrected distance (CDVA), distance-corrected intermediate (DCIVA) and near (DCNVA) visual acuities, refractive accuracy, rotational stability, binocular defocus curve, contrast sensitivity, Patient Reported Spectacle Independence Questionnaire (PRSIQ), dysphotopsia, and Visual Function Index (VF-14) scores.

Thirty patients (60 eyes) were enrolled. Mean binocular logMAR UDVA, UIVA and UNVA were -0.01 ± 0.04, 0.13 ± 0.11 and 0.25 ± 0.11 respectively. Mean CDVA, DCIVA and DCNVA were −0.03 ± 0.06, 0.17 ± 0.09 and 0.31 ± 0.11 respectively. Mean refractive spherical equivalent was −0.42 ± 0.38, with all eyes within 1 D of target. No patient required spectacles for distance or intermediate vision; six patients used near correction occasionally. Six patients reported starbursts; one reported halos and no patients reported glare. Mean VF-14 score was 95.9.

Bilateral Acunex Vario implantation provided excellent binocular distance and intermediate vision with functional near vision. High levels of spectacle independence and patient satisfaction were achieved, with minimal photic phenomena.