Effect of minimonovision in bilateral implantation of a novel non-diffractive extended depth-of-focus intraocular lens: Defocus curves, visual outcomes, and quality of life

Abstract

Purpose To evaluate overall patient satisfaction, spectacle independence, visual acuity, and prevalence of optical phenomena following bilateral implantation of a new non-diffractive extended depth-of-focus intraocular lens targeted for minimonovision. Methods Multicenter prospective case series. Postoperative far and near visual acuity at 3 months and patient quality of life by NEI-VFQ-25 questionnaire were assessed. Postoperative evaluation included defocus curves analysis, spectacle independence assessment, and recording of photic phenomena. Results The study enrolled 97 eyes of 59 patients that underwent femtosecond-assisted cataract surgery with AcrySof IQ Vivity intraocular lens implantation. Thirty subjects (60 eyes) were eligible for analysis. After 3 months, postoperative achieved binocular uncorrected visual acuity was −0.03 ± 0.06 logarithm of the minimum angle of resolution for distance, 0.06 ± 0.06 logarithm of the minimum angle of resolution for intermediate, and 0.19 ± 0.03 logarithm of the minimum angle of resolution for near. Defocus curve showed a smooth profile with no abrupt decrease of visual acuity. Minimonovision significantly improved visual acuity compared to when minimonovision was neutralized, for values of defocus curves from −1 to −3 D ( p < 0.05). Twenty-six (87%) patients reported complete spectacle independence. High levels of satisfaction for distance and near vision resulted at VFQ-25 questionnaire. Only two patients complained of halos (6.7%) and one of them also of glare (3.3%). Conclusions Implantation of this new non-diffractive extended depth-of-focus intraocular lens with minimonovision resulted in satisfying far, intermediate, and near visual acuity with a consistent reduction of spectacle dependence and improvement in patient's quality of life.

Clinical Outcomes of a New Non-Diffractive Extended Depth-of-Focus Intraocular Lens Targeted for Mini-Monovision

“…Tecnis Symfony with mini-monovision on the other hand achieved better UIVA and UNVA (−0.02±0.03 and 0.09±0.05 logMAR, respectively), and was as good as the diffractive trifocal IOL AT LISA Tri 839 MP. 29 AcrySof IQ Vivity with mini-monovision approach provided better binocular UIVA at 66cm and UNVA at 40 cm (0.00 to 0.06 and 0.12 to 0.23) 13 , 15 , 16 than the isofocal EDOF lens in our study. In another AcrySof IQ Vivity study without mini-monovision 27 even the monocular UNVA was as high as 0.15±0.16 logMAR, but interestingly, all patients still needed an addition of at least +1.0 D for near.…”

Visual outcomes of non-diffractive extended-depth-of-focus and enhanced monofocal intraocular lenses: A case-control study

“…16 Furthermore, the mini-monovision technique has reportedly been used to improve near vision using EDoF IOLs. [17][18][19][20] Amelsfort et al 17 reported that when they adjusted emmetropia in the dominant eye and slight myopia in the nondominant eye (−0.25 D to −0.50 D), patients reported improved near visual acuity, better satisfaction, and higher spectacle independence. Additionally, Newsom et al 19 revealed that when −0.75 D myopia was targeted in the nondominant eye, near visual acuity improved by more than a line than in other related studies targeting bilateral emmetropia.…”

“…Also, as previously stated, near spectacle independence can be enhanced by using the mini-monovision approach. [17][18][19][20] However, further researchs are warranted to examine the outcomes of Eyhance IOL with the mini-monovision technique.…”

A Comparative Study of Two Extended Depth of Focus Intraocular Lenses

“…According to previous studies, UDVA and CDVA were similar between EDOF and monofocal IOL. 27,28 Earlier studies have reported monocular UDVAs of 0.1360.13, 29 0.0160.09, 30 and 0.0260.04 31 for Symfony and 0.1260.14, 28 0.0060.08, 32 , and 20.0160.07 33 Vivity. Earlier studies have reported monocular CDVAs of 20.0560.06, 30 0.0160.03, 34 and 0.0560.08 29 for Symfony and 0.0160.05, 28 20.0260.06, 32 and 20.0160.06 33 for Vivity.…”

“…27,28 Earlier studies have reported monocular UDVAs of 0.1360.13, 29 0.0160.09, 30 and 0.0260.04 31 for Symfony and 0.1260.14, 28 0.0060.08, 32 , and 20.0160.07 33 Vivity. Earlier studies have reported monocular CDVAs of 20.0560.06, 30 0.0160.03, 34 and 0.0560.08 29 for Symfony and 0.0160.05, 28 20.0260.06, 32 and 20.0160.06 33 for Vivity. Similarly, in the present study, the UDVA value was 0.0760.06 and 0.1060.06 and the CDVA value was 0.0160.03 and 0.0160.04 in the Symfony and Vivity groups, respectively.…”