Visual and refractive outcomes of three distinct extended depth-of-focus (EDOF) intraocular lens technologies...

To compare refractive outcomes following bilateral implantation of three distinct extended depth-of-focus (EDOF) intraocular lens (IOL) technologies.

Three EDOF IOL technologies implanted in eligible patients were assessed: non-diffractive (NDEDOF) Vivity®, bifocal refractive (REDOF) LENTIS® Comfort, diffractive (DEDOF) AT LARA®. A monofocal IOL (Clareon® Aspheric) was used as a comparator. Corrected and uncorrected distance, intermediate (IVA) and near (NVA) visual acuities were assessed at 1 and 3months. The occurrence of photic phenomena (PP) and spectacle independence were assessed at 1 and 3months using a modified McAlinden questionnaire.

Ninety-two patients were analyzed. Binocular corrected distance visual acuity of 10/10 was achieved in 100% of patients in the monofocal, REDOF, and NDEDOF groups, and in 95% of the DEDOF group (P=0.98). Uncorrected intermediate and near visual acuities were better with EDOF IOLs compared to monofocal IOLs, with mean values of -0.1 and -0.2 logMAR, respectively. Photic phenomena were absent or mild (score<4/27) in 75% (NDEDOF), 78% (REDOF), 66% (DEDOF), and 91% (monofocal) of patients. The mean PP score was highest with the DEDOF lens (3.5/27, P<0.05). Spectacle independence was greater in the EDOF groups, with a mean score of 3-4/15 (high independence), compared to>7/15 in the monofocal group.

Regardless of optical design, the EDOF IOLs provided better intermediate and near vision and greater spectacle independence compared to the monofocal IOL. Photic phenomena were generally mild, although more frequent with the diffractive design.