Clinical Outcomes After Bilateral Implantation Of A Refractive Extended Depth Of Focus Intraocular Lens With Mini-Monovision

To assess the visual and functional clinical outcomes of a new fully refractive extended depth-of-focus intraocular lens following bilateral implantation with a mini-monovision approach.

This single center, prospective, interventional clinical trial was conducted at the Department of Ophthalmology and Optometry at the Medical University of Vienna

A total of 30 patients (60 eyes) with age-related cataract received bilaterally either a Tecnis PureSee ZEN00V IOL or, in eyes with >1.00 D corneal astigmatism, a toric Tecnis PureSee DET IOL (Johnson & Johnson Vision). Target refraction was plano in the dominant eye and −0.50 D in the non-dominant eye. At 2–6 months postoperatively, binocular uncorrected and distance-corrected visual acuity (UCDVA, BCDVA, UCIVA, DCIVA, UCNVA, DCNVA) was measured with the intended mini-monovision, and contrast sensitivity (CSV-1000; Vector-Vision) was assessed with and without mini-monovision under photopic, mesopic, and mesopic glare conditions. Internal higher-order aberrations, spherical aberration, and uncorrected defocus curves were also evaluated.

Mean binocular uncorrected distance (UCDVA), intermediate (UCIVA at 80 and 66 cm), and near (UCNVA) visual acuity were −0.01 ± 0.08, 0.05 ± 0.08, 0.10 ± 0.08, and 0.25 ± 0.08 logMAR, respectively. Corresponding distance-corrected values with mini-monovision (BCDVA, DCIVA, DCNVA) were −0.02 ± 0.06, 0.06 ± 0.07, 0.10 ± 0.07, and 0.25 ± 0.07 logMAR (all P > 0.05). The mean defocus curve ranged from 0.06 ± 0.07 logMAR at +0.50 D to 0.27 ± 0.11 logMAR at −2.50 D. Internal higher-order aberrations and spherical aberration were 0.45 ± 0.11 µm and −0.28 ± 0.08 µm at a 5-mm pupil, and 0.24 ± 0.16 µm and −0.03 ± 0.09 µm at a 3-mm pupil. Contrast sensitivity was similar with and without mini-monovision across all tested conditions (P > 0.05).

The Tecnis PureSee IOL (ZEN00V and DET), bilaterally implanted with a targeted mini-monovision of −0.50 D, provided good uncorrected distance and intermediate visual acuity, as well as satisfactory near visual acuity (0.25 ± 0.08 logMAR). The defocus curve showed a depth of focus of −1.90 D at 0.2 logMAR. Internal higher-order aberrations (HOAs) and spherical aberration (SA) were comparable to those reported for other EDOF IOLs. Mini-monovision had no significant effect on contrast sensitivity.