Extended Depth of Field Intraocular Lens for Cataract After Vitrectomy for Retinal Detachment: A Prospective Trial

This study aimed to evaluate visual outcomes and patient satisfaction following implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens (IOL) in eyes with cataract developing after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).

Patients who underwent PPV for RRD, with or without macular involvement, and subsequently developed cataract were prospectively enrolled. Cataract surgery was performed with implantation of the Vivity EDOF-IOL (Alcon). Bilateral implantation was performed according to patient preference. Inclusion criteria were attached retina 3-6 months after PPV and corrected distant visual acuity of 0.3-0.7 logMAR. Primary outcomes were monocular and binocular, corrected and uncorrected distance, intermediate, and near visual acuity (CDVA, UDVA, DCIVA, UIVA, DCNVA, UNVA) at 6 months. Secondary outcomes included defocus curve and patient-reported satisfaction.

Twenty-seven patients (43 eyes) underwent surgery at 6 ± 3 months after PPV (16 patients bilateral). Thirteen patients had RRD with macular involvement. In the RRD-affected eyes CDVA improved statistically significantly from 0.35 ± 0.16 to 0.03 ± 0.12 and UDVA from 1.01 ± 0.34 to 0.16 ± 0.19 logMAR at 6 months. Mean visual acuities at 6 months for RRD-affected eyes were DCIVA 0.53 ± 0.21, UIVA 0.44 ± 0.15, DCNVA 0.59 ± 0.23, and UNVA 0.47 ± 0.23 logMAR. Binocular UDVA, UIVA, and UNVA for the bilateral cases were - 0.04 ± 0.11, 0.29 ± 0.10, and 0.26 ± 0.13 logMAR, respectively. The defocus curve was comparable between macula-on, macula-off, and fellow eyes. Patient satisfaction was favorable with just two patients reporting halos.

Using the Vivity EDOF-IOL in selected patients with cataract after successful PPV for RRD appears to be a safe and effective option, yielding favorable visual outcomes regardless of macular involvement.

DRKS00037029.