Impact Of Preoperative Spherical Aberration On Refractive Outcomes With An Extended Depth-Of-Focus (Edof) Intraocular Lens (Iol)

To determine the correlation between preoperative corneal spherical aberration (SA) and visual performance at different distances after implantation of the AcrySof IQ Vivity® extended depth-of-focus (EDOF) intraocular lens (IOL). 

Association for the Prevention of Blindness in Mexico (Asociación Para Evitar la Ceguera en México I.A.P; APEC) Mexico City, Mexico (September 2023-December 2024).

Prospective study including 121 eyes undergoing phacoemulsification with implantation of the Vivity® EDOF IOL (Alcon). Pre- and postoperative corneal SA was evaluated using aberrometry (OPD-Scan III, Nidek) and corneal tomography (Pentacam, Oculus). Visual acuity (VA) was assessed with defocus curves for distance, intermediate and near vision. Statistical analyses included Wilcoxon tests, Student's t-test, Spearman correlation, and linear regression.

No significant differences were found between pre- and postoperative corneal SA (p=0,41). In the overall analysis, SA did not correlate with VA at any distance. Nevertheless, subgroup analysis showed that in patients with SA > 0,27 µm (34%), higher SA was significantly associated with worse intermediate visual performance (r=0,45; p<0,05), explaining 20,2% of its variability. No significant association was found between pupil size and VA at different distances.

Preoperative corneal SA influences intermediate vision quality with the Vivity® IOL, particularly in eyes with values > 0,27 µm. Preoperative SA assessment is a useful variable to select candidates and predict outcomes, thereby optimizing patient satisfaction with this EDOF technology.