Comparison of visual and subjective outcomes between two EDOF intraocular lenses, with emphasis on mesopic...

To evaluate outcomes after implantation of 2 extended depth-of-focus intraocular lenses (IOLs), with emphasis on performance in dim light.

2 clinical practices in the United States.

Prospective, double-masked, randomized clinical trial.

Participants were randomized to receive Symfony Optiblue or Vivity IOLs. Objective optical quality, aberrations, and simulated visual disturbances were measured before and 3 months postoperatively. Binocular visual acuity (VA), the defocus curve, and low contrast VA were measured under mesopic lighting conditions. Patient questionnaires were administered, and undirected patient comments were recorded.

31 participants in each group completed the study. Refractive outcomes were not significantly different. The Symfony lens provided about a half line better monocular mesopic VA at distance when uncorrected and best corrected ( P < .05). There were no differences in binocular visual function between lenses except for the mesopic defocus curve at -1.00 diopters (D) and -1.50 D, with the Symfony lens providing better VA at those vergences ( P < .02). Objective optical measures improved after surgery, with improvements not different by group. There were no differences in the size or intensity of simulated glare, but simulated halos and starburst size and intensity were significantly worse with the Symfony lens ( P < .05). Satisfaction with distance and intermediate vision in both groups was high. Reported visual disturbances were not significantly different between groups.

The 2 lenses provided similar visual performance in dim light, with the Symfony lens showing slightly better VA, but with more reports of halos and starbursts.