ESCRS - PP12.10 - Twelve-Month Clinical Outcomes Of A Refractive Extended Depth Of Focus Intraocular Lens: Visual Performance, Refractive Stability And Corneal Higher-Order Aberrations

Twelve-Month Clinical Outcomes Of A Refractive Extended Depth Of Focus Intraocular Lens: Visual Performance, Refractive Stability And Corneal Higher-Order Aberrations

Published 2026 - 44th Congress of the ESCRS

Reference: PP12.10 | Type: Free paper | DOI: 10.82333/t1xz-an25

Authors: Dr Karolina Pielak-Modrzejewska 1 , A/Prof. Jacek Szaflik* 2 , Dr Emilia Babula 1 , Dr Katarzyna Nowik 1 , Dr Agata Ordon 2 , Dr Justyna Izdebska 2 , Dr Anna Kamińska 2 , Dr Tomasz Gałecki 1

1Department of Ophthalmology, Medical University of Warsaw,Warsaw,Poland;SPKSO Ophthalmic University Hospital,Warsaw,Poland, 2Department of Ophthalmology, Medical University of Warsaw,Warsaw,Poland;SPKSO Ophthalmic University Hospital,Warsaw,Poland;Laser Eye Microsurgery Centre Clinic of Prof. Jerzy Szaflik,Warsaw,Poland

Purpose

To evaluate 12-month visual, refractive, and optical outcomes following bilateral implantation of a refractive extended depth of focus (EDOF) intraocular lens (TECNIS PureSee™, Johnson & Johnson Vision). The study assessed distance, intermediate, and near visual acuity, refractive stability, contrast sensitivity, dysphotopsia incidence, and changes in corneal higher-order aberrations (HOAs). Additionally, correlations between specific HOA components and postoperative visual acuity were analyzed to explore potential optical predictors of visual performance.

Setting

Prospective, interventional, non-randomized clinical study conducted at a tertiary ophthalmic center (SPKSO Ophthalmic University Hospital). All procedures were performed by experienced cataract surgeons.

Methods

Patients with bilateral cataract underwent sequential phacoemulsification with bilateral implantation of a refractive EDOF IOL using a planned micro-monovision strategy. Visual acuity (ETDRS, logMAR), manifest refraction, binocular contrast sensitivity (Pelli-Robson), dysphotopsia (Halo & Glare Simulator), corneal topography, and corneal HOAs (ANTERION) were assessed preoperatively and postoperatively. Defocus curve analysis was performed from +2.0 D to –4.0 D. Follow-up visits were scheduled at 1, 3, 6, and 12 months. Statistical analysis included paired t-test and Pearson correlation.

Results

Forty patients (80 eyes) completed 12-month follow-up. Mean UDVA was –0.008 ± 0.07 logMAR, UIVA 0.14 ± 0.11 logMAR, and UNVA 0.08 ± 0.15 logMAR. UNVA was significantly better than UIVA (paired t-test, p = 0.031). Binocular contrast sensitivity was 1.79 ± 0.09 logCS (40 cm) and 1.82 ± 0.08 logCS (100 cm). Mild halo-type dysphotopsia was reported by 8.33% of patients. No significant change in corneal HOAs was observed. Pearson correlations were found between UNVA and oblique trefoil (r = 0.669, p = 0.024), and between UDVA and spherical aberration (r = –0.685, p = 0.021), vertical coma (r = –0.604, p = 0.049), and oblique astigmatism (r = 0.602, p = 0.048).

Conclusions

At 12 months, implantation of this refractive EDOF IOL was associated with stable refractive outcomes, preserved contrast sensitivity, and low incidence of clinically relevant dysphotopsia. Near visual acuity was superior to intermediate acuity despite the use of micro-monovision, without compromising distance vision. The procedure did not induce measurable changes in corneal HOAs. Correlations between specific HOA components and visual acuity suggest that preoperative corneal optics may influence postoperative performance. These findings support the optical stability and functional predictability of this refractive EDOF platform.