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Related Experiment Video

Updated: Feb 3, 2026

$Subjective Refraction Test Using a Smartphone for Vision Screening$

Subjective Refraction Test Using a Smartphone for Vision Screening

Published on: October 18, 2024

Maximising Refractive Outcomes with an Extended Depth of Focus IOL.

Barry Power^1,2, Rory Murphy^1,2, Antonio Leccisotti^2,3

¹Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.

The Open Ophthalmology Journal

|October 30, 2018

Summary

Patients with over 1D of preoperative corneal astigmatism experienced significantly worse visual outcomes after cataract surgery with an extended depth of focus intraocular lens (Symfony IOL). Careful patient selection is crucial for optimal refractive results and spectacle independence.

Keywords:

Cataract surgery Corneal astigmatism Extended depth of focus IOL Refractive surgery SIA Symfony IOL

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Area of Science:

Ophthalmology
Refractive Surgery
Corneal Astigmatism

Background:

Cataract surgery with extended depth of focus intraocular lenses (IOLs) aims to improve uncorrected visual acuity at multiple distances.
Preoperative corneal astigmatism can influence refractive outcomes and patient satisfaction after IOL implantation.

Purpose of the Study:

To evaluate the impact of preoperative and postoperative corneal astigmatism magnitude on refractive outcomes following cataract surgery or lens exchange using a Symfony IOL.
To compare visual outcomes based on the location of corneal incisions (steep vs. temporal on-axis).

Main Methods:

Prospective cohort analysis of 53 adult patients (94 eyes) undergoing phacoemulsification with Symfony IOL implantation.
Data collected included pre- and postoperative refraction, keratometry, visual acuities (distance and near), and surgically induced astigmatism (SIA).

Main Results:

Low preoperative corneal astigmatism (0-0.99 D) was associated with statistically significantly better uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) compared to higher levels (>0.99 D).
No significant difference in visual outcomes or SIA was observed between steep and temporal on-axis corneal incisions.

Conclusions:

The Symfony IOL effectively addresses presbyopia and reduces spectacle dependence.
Caution is advised when considering spectacle independence for patients with over 1D of preoperative corneal astigmatism due to potentially inferior and less predictable visual results.