Visual Outcomes and Patient Satisfaction for Trifocal, Extended Depth of Focus and Monofocal Intraocular Lenses

Purpose. To evaluate the clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Setting. Asan Medical Center, Seoul, South Korea. Design. Prospective clinical study. Methods. Thirty-seven patients underwent TECNIS Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and TECNIS +3.25 DMF IOL (ZLB00) implantation in the nondominant eye. Patients were followed up for 3 months; uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) of UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients (81.1%) were more than satisfied with near vision, and 8 patients (21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients (91.9%), and 31 patients (83.8%) had better than a 50-second arc of stereopsis. Conclusion. Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes for all distances. Additionally, excellent patient satisfaction was achieved with a high level of spectacle independence and acceptable photic phenomena.

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Clinical Outcomes After Mix-and-Match Implantation of Extended Depth of Focus and Diffractive Multifocal Intraocular Lenses

10.20944/preprints202004.0423.v1 ◽

2020 ◽

Author(s):

Jae Hyuck Lee ◽

Ho Seok Chung ◽

Su Young Moon ◽

Hun Lee ◽

Jae Yong Kim ◽

...

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Cataract Surgery ◽

Clinical Outcomes ◽

Intraocular Lenses ◽

Depth Of Focus ◽

Near Vision ◽

Extended Depth Of Focus ◽

Dominant Eye ◽

Mix And Match

Purpose: To evaluate clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Methods: Thirty-seven patients received Tecnis Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and Tecnis +3.25 DMF IOL (ZLB00) in the non-dominant eye. Patients were followed for 3 months, and uncorrected and corrected distance visual acuity (UDVA, CDVA) , uncorrected intermediate and near visual acuity (UIVA, UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results: At 3 months, mean logMAR UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients(81.1%) were more than satisfied with near vision, and 8 patients(21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients(91.9%), and 31 patients(83.8%) had better than a 50 second arc of stereopsis. Conclusion: Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes through all distances. Also excellent patient satisfaction was achieved with high level of spectacle independence and minimal photic phenomena.

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Comparative Analysis of Visual Performance and Astigmatism Tolerance with Monofocal, Bifocal, and Extended Depth-of-Focus Intraocular Lenses Targeting Slight Myopia

Journal of Ophthalmology ◽

10.1155/2020/9283021 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Jie Xu ◽

Tianyu Zheng ◽

Yi Lu

Keyword(s):

Contrast Sensitivity ◽

Significant Negative Correlation ◽

Optical Quality ◽

Corneal Astigmatism ◽

Intraocular Lenses ◽

Visual Performance ◽

Depth Of Focus ◽

Visual Outcomes ◽

Extended Depth Of Focus ◽

Visual Function Questionnaire

Purpose. To compare the visual performance and astigmatism tolerance of 3 intraocular lens (IOL) groups: monofocal, bifocal, and extended depth-of-focus (EDOF) IOLs targeting slight myopia. Methods. Overall, there were 60 cataract surgery eyes from 60 patients with implantation of a monofocal, bifocal, or EDOF IOL (20 eyes in each IOL group). The EDOF IOLs targeted slight myopia (−0.25 D to −0.75 D). Intragroup comparison of visual acuity, defocus curve, objective optical quality, contrast sensitivity, visual function questionnaire scores, patients’ overall satisfaction, and the astigmatism tolerance was performed 3 months after surgery. Results. The EDOF group provided equivalently excellent distance visual outcomes (0.06 ± 0.12) as the monofocal (0.06 ± 0.09) and bifocal (0.03 ± 0.09) groups P = 0.554 , better intermediate vision than the other 2 groups P < 0.05 , and similarly satisfactory near visual outcomes (0.23 ± 0.16 at 20 cm, and 0.17 ± 0.14 at 33 cm) as the bifocal group (0.28 ± 0.14 at 20 cm and 0.08 ± 0.10 at 33 cm) P > 0.05 . The contrast sensitivity of EDOF IOL was slightly decreased compared to that of monofocal IOL, but it was better than that of bifocal IOL. The EDOF group showed significantly higher satisfaction than the bifocal group did when preoperative corneal astigmatism was 0.75 D or greater P = 0.009 . A significant negative correlation between the corneal astigmatism and patient satisfaction was observed in only the bifocal group. Conclusions. The EDOF IOLs targeting slight myopia offered satisfactory visual outcomes at an extended range from far to near distances. The EDOF and monofocal IOLs showed a better tolerance to astigmatism than did the bifocal IOL.

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First Experience of Multifocal and Toric Extended Depth of Focus Intraocular Lenses Implantation (Short-Term Analysis)

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-3-408-414 ◽

2021 ◽

Vol 18 (3) ◽

pp. 408-414

Author(s):

К. B. Pershin ◽

N. F. Pashinova ◽

А. Yu. Tsygankov ◽

E. A. Antonov

Keyword(s):

Patient Satisfaction ◽

Low Frequency ◽

Functional Results ◽

Intraocular Lenses ◽

Rotational Stability ◽

Depth Of Focus ◽

Short Term ◽

Extended Depth Of Focus ◽

Optical Phenomena

Aim. Analysis of the functional results of new IOL with an extended depth of focus implantation a in the short-term (6 months) follow-up period.Patients and methods. The prospective study included 27 patients (40 eyes) after bilateral (n = 12) or monolateral (n = 15) implantation of EDOF IOL Tecnis Symfony with an average follow-up period of 6.5 ± 0.2 (6–7) months. In all cases, IOL implantation was preceded by cataract phacoemulsification or removal of the transparent lens for refractive purposes. The age range was from 39 to 78 (60.6 ± 10.1) years. EDOF IOL Tecnis Symfony ZXR00 was implanted in 30 eyes, and toric EDOF IOL Tecnis Symfony ZXT100, ZXT150, ZTX225, and ZXT300 were implanted in 10 eyes in the presence of clinically significant astigmatism.Results. An increase in UCNVA from 0.18 ± 0.04 to 0.79 ± 0.11, UCIVA from 0.21 ± 0.07 to 0.89 ± 0.10, UCDVA from 0.24 ± 0.06 to 0.95 ± 0.16, BCNVA from 0.61 ± 0.05 to 0.80 ± 0.03, BCIVA from 0.58 ± 0.10 to 0.97 ± 0.19, and BCDVA from 0.65 ± 0.08 to 1.0 ± 0.06 (p < 0.05 in all cases). The spherical equivalent of refraction decreased from –4.5 ± 1.8 in the preoperative period to –0.18 ± 0.92 in the follow-up period of 6 months after implantation of the Tecnis Symfony ZXR00 IOL. In the group with toric IOLs, a decrease in the cylindrical component of refraction was shown from 1.33 ± 1.02 (modulo) to 0.61 ± 0.44 (modulo) during the maximum observation period. In all cases, the rotational stability of the implanted IOLs was noted. In 9 patients out of 24 (37.5 %), permanent or periodic optical phenomena were detected, of which 4 patients (16.7 %) had halos, 3 (12.5 %) had glare, and 2 (8.3 %) had difficulty driving in the dark. These side effects did not affect the overall patient satisfaction — 22 patients (91.7 %) rated the result of the operation as “excellent”, and 2 patients (8.3 %) — as “good”.Conclusion. The paper presents an analysis of the first experience in the Russian Federation of implantation of new IOLs with extended depth of focus and their toric version in 27 patients. Data on the effectiveness of this IOL for vision correction at all distances, low frequency of side optical phenomena, and high patient satisfaction are presented. Further comparative studies with other multifocal IOLs are needed.

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Comparative analysis of visual performance and astigmatism tolerance with monofocal, bifocal, and extended depth-of-focus intraocular lenses targeting slight myopia

10.21203/rs.2.19178/v1 ◽

2019 ◽

Author(s):

Jie Xu ◽

Tianyu Zheng ◽

Yi Lu

Keyword(s):

Contrast Sensitivity ◽

Significant Negative Correlation ◽

Optical Quality ◽

Corneal Astigmatism ◽

Intraocular Lenses ◽

Visual Performance ◽

Depth Of Focus ◽

Visual Outcomes ◽

Extended Depth Of Focus ◽

Visual Function Questionnaire

Abstract BackgroundTo compare the visual performance and astigmatism tolerance of 3 intraocular lens (IOLs): monofocal, bifocal, and extended depth-of-focus (EDOF) IOLs targeting slight myopia.MethodsOverall, there were 60 cataract surgery eyes from 60 patients with implantation of a monofocal, bifocal or EDOF IOL (20 eyes in each IOL group). The EDOF IOLs targeted slight myopia (-0.25 D to -0.75 D). Intragroup comparison of visual acuity, defocus curve, objective optical quality, contrast sensitivity, Visual function questionnaire scores, patients’ overall satisfaction, and the astigmatism tolerance were performed 3 months after surgery.ResultsThe EDOF group provided equivalently excellent distance visual outcomes (0.06±0.12) as the monofocal (0.06±0.09) and bifocal (0.03±0.09) groups (P=0.554), better intermediate vision than the other 2 groups (P<0.05), and similarly satisfactory near visual outcomes (0.23±0.16 at 20 cm, and 0.17±0.14 at 33 cm) as the bifocal group (0.28±0.14 at 20 cm, and 0.08±0.10 at 33 cm) (P>0.05). The contrast sensitivity of EDOF IOL was slightly decreased compared to that of monofocal IOL, but it was better than that of bifocal IOL. The EDOF group showed significantly higher satisfaction than the bifocal group did when preoperative corneal astigmatism was 0.75 D or greater (P=0.009). A significant negative correlation between the corneal astigmatism and patient satisfaction was observed in only the bifocal group. ConclusionsThe EDOF IOLs targeting slight myopia offered satisfactory visual outcomes at an extended range from far to near distances. The EDOF and monofocal IOLs showed a better tolerance to astigmatism than did the bifocal IOL.

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Analys of multifocal and toric extended depth of focus intraocular lenses implantation

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-5-76-79 ◽

2021 ◽

pp. 76-79

Author(s):

K.B. Pershin ◽

◽

N.F. Pashinova ◽

А.I. Tsygankov ◽

E.A. Antonov ◽

...

Keyword(s):

Patient Satisfaction ◽

Functional Results ◽

Intraocular Lenses ◽

Rotational Stability ◽

Depth Of Focus ◽

Multifocal Iol ◽

Extended Depth Of Focus ◽

Toric Iols ◽

Optical Phenomena

Purpose. Analysis of the functional results of new IOL with an extended depth of focus implantation a in the short-term (6 months) follow-up period. Material and methods. The prospective study included 27 patients (40 eyes) after bilateral (n=12) or monolateral (n=15) implantation of EDOF IOL Tecnis Symfony with an average follow-up period of 6.5±0.2 (6-7) months. In all cases, IOL implantation was preceded by cataract phacoemulsification or removal of the transparent lens for refractive purposes. The age range was from 39 to 78 (60.6±10.1) years. EDOF IOL Tecnis Symfony ZXR00 was implanted in 30 eyes, and toric EDOF IOL Tecnis Symfony ZXT100, ZXT150, ZTX225, and ZXT300 were implanted in 10 eyes in the presence of clinically significant astigmatism. Results. An increase in UCNVA from 0.18±0.04 to 0.79±0.11, UCIVA from 0.21±0.07 to 0.89±0.10, UCDVA from 0.24±0.06 to 0.95±0.16, BCNVA from 0.61±0.05 to 0.80±0.03, BCIVA from 0.58±0.10 to 0.97±0.19, and BCDVA from 0.65±0.08 to 1.0±0.06 (p<0.05 in all cases). The spherical equivalent of refraction decreased from -4.5±1.8 in the preoperative period to -0.18±0.92 in the follow-up period of 6 months after implantation of the Tecnis Symfony ZXR00 IOL. In the group with toric IOLs, a decrease in the cylindrical component of refraction was shown from 1.33±1.02 (modulo) to 0.61±0.44 (modulo) during the maximum observation period. In all cases, the rotational stability of the implanted IOLs was noted. In 9 patients out of 24 (37.5%), permanent or periodic optical phenomena were detected, of which 4 patients (16.7%) had halos, 3 (12.5%) had glare, and 2 (8.3%) had difficulty driving in the dark. These side effects did not affect the overall patient satisfaction – 22 patients (91.7%) rated the result of the operation as "excellent", and 2 patients (8.3%) – as "good". Conclusion. The paper presents an analysis of the first experience in the Russian Federation of implantation of new multifocal and toric IOLs with extended depth of focus in 27 patients. Data on the effectiveness of this IOL for vision correction at all distances, low frequency of side optical phenomena, and high patient satisfaction are presented. Further comparative studies with other multifocal IOLs are needed. Key words: cataract; presbyopia; multifocal IOL; IOL with extended depth of focus; EDOF; Symphony.

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Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-86222-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yueyang Zhong ◽

Kai Wang ◽

Xiaoning Yu ◽

Xin Liu ◽

Ke Yao

Keyword(s):

Systematic Review ◽

Visual Acuity ◽

Meta Analysis ◽

Visual Quality ◽

Intraocular Lenses ◽

Depth Of Focus ◽

Refractive Lens Exchange ◽

Extended Depth Of Focus ◽

Refractive Lens ◽

Near Visual Acuity

AbstractThis meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: − 0.143, 95% CI: − 0.192 to − 0.010, P < 0.001 and MD: − 0.149, 95% CI: − 0.217 to − 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.

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