Clinical Tolerance to Induced Astigmatism in Eyes Implanted with a Single Extended Depth of Focus Intraocular Lens...

To evaluate clinical tolerance to induced astigmatism in pseudophakic eyes bilaterally implanted with an extended depth of focus (EDOF) intraocular lens (AT LARA^®, Carl Zeiss Meditec). We hypothesized that small amounts of induced astigmatism may be clinically well tolerated by patients implanted with this EDOF IOL.

Prospective study including 10 patients (20 eyes) bilaterally implanted with the same EDOF IOL. Monocular defocus curves were obtained under photopic conditions after introducing cylindrical lenses of +1.00 D, +2.00 D, and +3.00 D at with-the-rule (WTR) and against-the-rule (ATR) orientations.

The IOL demonstrated good tolerance up to +1.00 D of induced astigmatism, with significant reductions in visual acuity at higher magnitudes of astigmatism. Tolerance was higher for ATR astigmatism compared to WTR, consistent with axis-dependent depth-of-focus effects.

The AT LARA^® EDOF IOL maintained functional visual performance with up to +1.00 D of regular astigmatism, while higher magnitudes led to clinically meaningful degradation. Axis orientation modulated performance, with ATR preserving intermediate and near vision and WTR favoring distance.