Tolerance to Simulated Astigmatism and Patient-Reported Outcomes of a Violet Light-Filtering Diffractive Full Visual...

To assess the tolerance to simulated astigmatism and patient-reported outcomes in pseudophakic eyes implanted with a violet light-filtering diffractive full visual range intraocular lens (VLF FVR IOL).

This prospective, observational study included 30 patients who had cataract surgery with the implantation of a VLF FVR IOL (Tecnis Odyssey, DXR00V & DRT models; Johnson & Johnson Vision). Visual outcomes were assessed 1 to 3 months postoperatively. Cylindrical defocus was induced using +0.50 to +2.00 diopters (D) cylinder lenses in 0.50-D increments for with-the-rule (WTR), oblique, and against-the-rule (ATR) orientation over the patient's corrected distance refraction. The tolerance to simulated astigmatism was evaluated by calculating the difference between distance visual acuity at each defocus and corrected distance visual acuity without defocus. The patient's reported outcomes were analyzed using the Assessment of IOL Implant Symptoms (AIOLIS) questionnaire.

More than 90% of patients achieved visual acuity of 20/40 or better with 1.50 D WTR and 1.00 D oblique/ATR astigmatism. WTR astigmatism resulted in visual acuity within one line for up to 1.00 D and two lines for 1.50 D, outperforming ATR, which achieved it for 0.50 and 1.50 D, followed by oblique, which resulted in 0.50 and 1.00 D, respectively. Induced 1.00 D WTR astigmatism demonstrated better visual acuity than ATR (P = .04) and oblique (P = .03). Starbursts, halos, and snowballs were reported as severe in 3% of patients, whereas 7% experienced glare at night. Notably, 96.6% of patients reported spectacle independence.

The VLF FVR IOL showed good tolerance to induced astigmatism for distance vision, with WTR astigmatism being better tolerated than oblique and ATR orientations. The AIOLIS questionnaire showed a strong level of patient satisfaction and optical phenomena.