Evaluation of Visual and Patient-Reported Outcomes After Implantation of Extended Depth of Focus Intraocular Lenses in Patients Not Suitable for Multifocal Lenses

Abstract

Purpose To evaluate the visual and patient-reported outcomes of patients undergoing cataract surgery with implantation of an extended depth of focus (EDOF) intraocular lens (IOL) who were not good candidates for multifocal IOL implantation Methods Retrospective analysis of data from 30 eyes (23 patients) undergoing cataract surgery with implantation of one of two EDOF IOLs (follow-up: 37.9 ± 16.2 months), and prospective observational study including 106 eyes (78 patients) implanted with one of 6 different EDOF models (follow-up: 8.0 ± 7.7 months). Patients recruited had one of the following conditions: monofocal IOL implanted in the fellow eye, previous corneal refractive surgery, mild and non-progressive maculopathy or glaucoma, age > 75 years, amblyopia, or previous vitrectomy. Results In the retrospective phase, significant improvements were found in uncorrected distance (UDVA), corrected distance (CDVA) and corrected near visual acuity (CNVA) (p ≤ 0.013), with a non-significant trend to improvement in uncorrected near visual acuity (UNVA). A total of 90% of patients were completely to moderately satisfied with the outcome achieved. In the prospective phase, significant improvements were found in UDVA, CDVA, UNVA and CNVA (p ≤ 0.032), with a total of 85.5% of patients being completely to moderately satisfied (dissatisfaction 3.3%). In both phases, extreme difficulties were only reported by a limited percentage of patients for performing some near vision activities. Conclusions EDOF IOLs should be considered as a new therapeutic option in this type of patients, being a viable alternative to monofocal IOLs.