Visual performance of an extended depth of focus intraocular lens for treatment selection.

PURPOSE: To evaluate the visual performance of an extended depth of focus (EDOF) intraocular lens (IOL) for patient selection. METHODS: This prospective non-comparative case series evaluated fifty-two eyes (26 patients) after bilateral implantation of the Tecnis Symfony IOL. Exclusion criteria were previous ocular surgeries, corneal astigmatism of >1.5 diopter, and ocular pathologies or corneal abnormalities. Uncorrected (UCVA) and distance-corrected (DCVA) visual acuity (VA) in 4 m, 80 cm, 60 cm and 40 cm (logMAR), defocus curve, contrast sensitivity (CS) and a questionnaire on subjective quality of vision (QoV) were assessed after 3 months. RESULTS: UCVA was -0.02 ± 0.071 logMAR at 4 m, 0.01 ± 0.077 logMAR at 80 cm, 0.08 ± 0.187 logMAR at 60 cm and 0.22 ± 0.153 logMAR at 40 cm. Defocus curve testing showed a flat VA range from 0.00 to -1.50 D (-0.05-0.02 logMAR). At near distance from -2.0 to -2.5 D a dip of DCVA was observed (0.14-0.28 logMAR). CS under photopic and mesopic conditions without and with glare was 1.56 logCS, 0.86 logCS, 0.78 logCS, respectively. Spectacle independence was achieved in 100% for distance and intermediate vision and 71% of patients at near distance. CONCLUSION: This EDOF IOL provides excellent intermediate and far (<0.1 logMAR) and acceptable near UCVA (<0.3 logMAR). Defocus curve testing confirmed an EDOF between far and intermediate distance and showed a dip at near distance. It provides good QoV, CS, high spectacle independence, perception of few optical phenomena, and particularly good night-driving capabilities.

Visual Outcomes After Implantation of a Segmental Refractive Multifocal Intraocular Lens Following Cataract Surgery.

PURPOSE: To evaluate visual outcomes, with particular attention to intermediate visual acuity (VA), of a segmental refractive multifocal intraocular lens (IOL) with optimized depth of focus (DoF). DESIGN: Prospective, nonrandomized, noncomparative case series. METHODS: Setting: Department of Ophthalmology, Goethe University, Frankfurt/Germany. Patient or Study Population: Fifty eyes (25 patients) were included. Inclusion criteria were bilateral cataract, age > 45 years, corneal astigmatism ≤ 0.75 diopter (D) postoperatively, pupil size 3-6 mm (mesopic), and center shift < 1 mm (Pentacam). Exclusion criteria were ocular surgeries, amblyopia, or potential postoperative distance-corrected VA (DCVA) > 0.3 logMAR. Intervention or Observation: Uncorrected (UCVA) and DCVA in 4 m, 80 cm, 40 cm; contrast sensitivity (CS); reading skills; defocus curve; and questionnaire on optical quality (OQ) and spectacle independence were assessed after 3 months. MAIN OUTCOME MEASURES: UCVA and DCVA in 4 m, 80 cm, 40 cm; defocus curve. RESULTS: UCVA was 0.05 ± 0.122 logMAR at 4 m, 0.18 ± 0.164 logMAR at 80 cm, and 0.16 ± 0.140 logMAR at 40 cm. Defocus curve testing showed, respectively, a flat monocular and binocular VA range from 0.00 to -2.00 D (-0.03 to 0.11 logMAR, -0.05 to 0.05 logMAR). Median CS under photopic and mesopic conditions without and with glare was 1.81 logCS, 1.65 logCS, 1.52 logCS, and 1.14 logCS, respectively. Reading speed at 40 cm showed a reading acuity of 0.100 logRAD with 94 words/minute. CONCLUSION: This segmental multifocal IOL provides good VA at all distances (<0.20 logMAR), particularly providing good intermediate visual acuity and DoF. It showed good reading skills, OQ, and CS and high spectacle independence.