Visual performance after bilateral toric extended depth-of-focus IOL exchange targeted for micromonovision

Abstract

Purpose: To evaluate overall patient satisfaction, spectacle independence, binocular visual acuity, rotational stability, prevalence of optical phenomena, and decentration and tilt after bilateral toric extended depth-of-focus intraocular lens (EDOF IOL) implantation targeted for micromonovision. Setting: Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. Design: Prospective case series. Methods: The study included 52 eyes of 26 patients with regular corneal astigmatism from 0.75 to 2.60 diopters (D) that were implanted bilaterally with a toric EDOF IOL targeted for micromonovision. Postoperative visual acuity, astigmatism reduction, rotation, tilt, decentration, spectacle independence, patient satisfaction, and photic phenomena were assessed. Results: For the 52 eyes studied, binocular means expressed in logarithm of the minimum angle resolution for postoperative corrected distance, uncorrected distance, uncorrected intermediate, and uncorrected near visual acuities were −0.10 (±0.12), −0.01 (±0.13), 0.01 (±0.14), and 0.13 (±0.14), respectively. Mean refractive astigmatism reduction was 1.31 ± 0.67 D resulting in a mean refractive cylinder of 0.47 ± 0.46 D at the 3-month visit. Mean postoperative rotation was 3.5 ± 3.5 degrees, at the 3-month time point. Most prevalent dysphotopsia were halos, starburst, and glare affecting 6 (23%), 6 (23%), and 5 (19%) of 26 patients, respectively; 20 (77%) of 26 patients reported spectacle independence, with 19 (95%), 19 (95%), and 14 (70%) of 20 patients questioned being satisfied with distance, intermediate, and near vision, respectively. Conclusions: Toric EDOF IOL implantation targeted for micromonovision resulted in reliable reduction of preoperative astigmatism with a high degree of postoperative rotational predictability and centration, enabling functional distance, intermediate, and near vision, which manifested itself in high patient satisfaction.

Visual outcomes of a new nondiffractive extended depth-of-focus intraocular lens targeted for minimonovision: 3-month results of a prospective cohort study

“…10,11,15 The binocular UIVA results are similar in our study, and the difference of 0.06 to 0.03 logMAR is, in our opinion, not clinically relevant. 10,15 Concerning the binocular UNVA at 40 cm, the aforementioned studies reported better results when compared with our study (ranging from 0.09 logMAR to 0.152 logMAR). 10,11,15 The Eyhance is marketing itself as an enhanced monofocal and not EDoF IOL, this better accurately depicts the Eyhance IOL.…”

“…10,15 Concerning the binocular UNVA at 40 cm, the aforementioned studies reported better results when compared with our study (ranging from 0.09 logMAR to 0.152 logMAR). 10,11,15 The Eyhance is marketing itself as an enhanced monofocal and not EDoF IOL, this better accurately depicts the Eyhance IOL. The TECNIS Eyhance (Johnson & Johnson) is an enhanced monofocal IOL design which is promising added intermediate vision but with a monofocal disturbance profile.…”

Comparison of rotational stability and repositioning rates of 2 presbyopia-correcting and 2 monofocal toric intraocular lenses

“…3 An important feature of our study was the use of digital axis marking (Callisto, Carl Zeiss Meditec AG) in every case to differentiate postoperative rotation from surgical misalignment. 11,12 In our comparison of the 2 most common monofocal TIOL models in the United States—647 eyes with ZCT TECNIS IOL (Johnson & Johnson Vision) and 626 eyes with AcrySof IOL (Alcon Laboratories, Inc.)—significantly more TECNIS than AcrySof TIOLs were more than 5 (18.2% vs 8.1%, P < .0001), more than 10, and more than 15 degrees misaligned.…”

“…A study of 52 eyes with Symfony toric IOLs using digital marking reported mean rotation of 3.5 ± 3.5 degrees. 11 Both of these SPA foldable PCIOLs use the same platforms as their monofocal counterparts with the exception of the diffractive optic. This study expands our previous TIOL study to include all monofocal and PC-TIOLs implanted from September 2016 to January 2019 to compare the rotational stability and repositioning rates of both monofocal and PC-TIOLs.…”

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

“…For two of the EDOF IOLs available on the market, the use of mini-monovision has been found to significantly improve uncorrected binocular visual acuity and spectacle independence. [4][5][6][7][8][9][10][11][12][13][14][15][16] Isopure® is a hydrophobic aspheric non-diffractive IOL. Its EDOF properties are based on a polynomial surface design across the full optic providing a high amount of negative spherical aberrations, smoothly increasing from the center to the periphery of the optic.…”