Visual Outcomes Of A Non-Diffractive Wavefront-Linking Extended Depth Of Focus Intraocular Lens In Non-Standard Eyes

To evaluate visual, refractive and patient-reported outcomes following implantation of the Medicontur ELON intraocular lens(IOL) in non-standard eyes, including post-refractive surgery and eyes undergoing combined epiretinal membrane(ERM) removal.

LEC Eye Centre, Ipoh, Malaysia

This case series included 12 eyes of 7 patients undergoing phacoemulsification with implantation of the ELON IOL. Eight eyes had previous corneal refractive surgery, while four eyes underwent combined phacoemulsification with pars plana vitrectomy and ERM peeling. Postoperative assessments at 3 months included logMAR uncorrected distance(UDVA), intermediate (UIVA) and near visual acuity(UNVA), corrected distance(CDVA), distance corrected intermediate (DCIVA) and distance corrected near visual acuity(DCNVA), manifest refraction and refractive predictability. Where available, defocus curve analysis was performed. Patient-reported outcomes included spectacle independence, dysphotopsia symptoms and VF-14 quality of life questionnaire.

Mean postoperative UDVA was 0.14+0.14, with 72.8% of eyes achieving 0.2 logMAR or better. Mean UIVA and mean UNVA were 0.30+0.22 and 0.40+0.13 respectively. Mean CDVA was 0.05+0.08 with 100% of eyes achieving 0.2 logMAR or better. Mean DCIVA and DCNVA were 0.28+0.25 and 0.31+0.18 respectively.  Mean refractive spherical equivalent(MRSE) was     -0.13+0.39D, with 77.7% of eyes within ±0.50D of intended target. Only 2 patients reported needing spectacles for reading and 3 reported mild dysphotopsias. Mean VF-14 score was 90.59.

In this small real-world series of non-standard eyes, the Medicontur ELON IOL provided good distance and intermediate visual outcomes with acceptable refractive predictability and low incidence of dysphotopsias. ELON may be a viable option in selected complex eyes, although careful patient selection and larger studies are required.