Visual performance of an EDOF intraocular lens in patients with low to moderate irregular astigmatism

To assess visual and subjective outcomes in eyes with low to moderate irregular astigmatism following extended-depth-of-focus (EDOF) intraocular lens (IOL) implantation.

Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

Single-center, prospective, clinical trial.

This study assessed patients with low to moderate irregular astigmatism who received bilateral cataract surgery using the nontoric/toric AcrySof IQ Vivity IOL. At the 4-month examination, monocular and binocular corrected distance visual acuity (CDVA) and distance-corrected intermediate visual acuity (DCIVA), monocular 25% low-contrast CDVA and DCIVA, monocular distance-corrected near visual acuity (DCNVA) and corrected near visual acuity (CNVA), monocular defocus curve from +0.5 to -2.5 diopters (D), wavefront aberrometry, and subjective outcome (VF-7) were evaluated.

28 patients presenting low to moderate irregular astigmatism with mean 1.27 ± 0.83 D cylinder and 0.04 ± 0.01 μm/mm 2 root mean square per area were analyzed. At the follow-up visit, mean logMAR results were the following: Monocular CDVA was -0.01 ± 0.08, binocular CDVA was -0.08 ± 0.07, monocular DCIVA was 0.18 ± 0.11, binocular DCIVA was 0.08 ± 0.08, monocular 5% low-contrast CDVA was 0.40 ± 0.12, DCIVA was 0.38 ± 0.11, monocular DCNVA was 0.38 ± 0.09, and CNVA was 0.09 ± 0.09. Monocular defocus curves demonstrated 0.16 ± 0.09 logMAR at -1.5 D of defocus and ≤0.2 logMAR visual acuity up to -1.66 D of defocus. Difficulties during daily life activities (VF-7 questionnaire) were low.

In eyes with low to moderate irregular astigmatism, the AcrySof IQ Vivity IOL provided very good monocular and binocular visual performance at far and intermediate distance after bilateral cataract surgery. These findings suggest that low to moderate irregular astigmatism does not substantially decrease visual outcome following bilateral EDOF IOL implantation.