A Comparative Analysis Of Visual Quality And Multifocal Electroretinography In Extended Depth-Of-Focus And Monofocal Intraocular Lenses

To compare visual acuity and contrast sensitivity levels after Extended Depth-of-
Focus (EDOF) IOL (intraocular lens) and monofocal IOL implantation in cataract surgery and
to compare the effects of the IOLs on electrical activity in central retina.

This prospective cohort study included patients undergoing phacoemulsification with EDOF or monofocal intraocular lens implantation at Ege University,Izmir,Turkey.

The study included 23 eyes of 15 patients who underwent surgery
for senile cataracts and received an EDOF IOL (Vivity, Alcon, USA) (Group 1) and 21 eyes
of 15 patients who received an Alcon single-vision lens (AcrySof IQ in UltraSert, USA)
(Group 2). Post-operative corrected and uncorrected visual acuities for distance (CDVA,
UDVA), intermediate (CIVA, UIVA), and near (40-67 cm) (CNVA, UNVA) were measured.
Contrast sensitivity levels were assessed under mesopic conditions. Participants completed a
spectacle independence questionnaire. Multifocal electroretinography (mfERG) was used to
examine the amplitude and implicit time of the P1 wave in central retina (5-10 degrees).

Mean age was 60.4 ± 9.1 (range, 51-75) years in Group 1 and 63.2 ± 7.7 (range, 41-
73.) years in Group 2 (p=0.17). UDVA and CDVA were comparable between groups (p=0.66 and 0.15). Intermediate and near visual
acuities were significantly better in Group 1 (UIVA: 0.30 ± 0.11 vs 0.71 ± 0.17 LogMAR;
UNVA: 0.28 ± 0.10 vs 0.67 ± 0.15 LogMAR, p < 0.001). Mesopic contrast sensitivity at
spatial frequencies of 0.5, 1, 3, 6, and 12 cpd was 15.9, 17.7, 19.5, 15.08, and 7.58 dB in
Group 1, and 15.6, 18.3, 19.8, 16.4, and 8.5 dB in Group 2, respectively (p>0.05, all decibels).
MfERG revealed a mean P1 wave amplitude of 785.1 nV and implicit time of 45.8 ms in
Group 1, and 844.2 nV and 44.3 ms in Group 2, respectively (p=0.51 and 0.80). 

Functional vision at distance, intermediate, and near distances was found to be
satisfactory in patients that were EDOF IOLs were implanted, demonstrating significant
superiority over single-vision lenses, particularly at intermediate and near distances. No
significant differences were observed between the two groups in terms of mesopic contrast
sensitivity and central retinal electrical activity parameters assessed by mfERG.