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  • Visual Disturbances With EDOF Lenses

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    Journal of Cataract and Refractive Surgery
    Published online June 20, 2022

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    Although monofocal IOLs are widely used and produce good distance vision, they now have competition from an array of multifocal lenses that may improve near and/or mid-range vision as well. With the newer lenses, the risk of visual disturbances such as glare and halos is relatively high, leading to dissatisfaction for some patients. Extended depth-of-focus (EDOF) lenses are designed to improve the full range of vision, but near vision may be inferior to that with bifocal IOLs because of overlapping images on the retina. To learn more about visual disturbances by lens type, Guarro et al. compared post-op results and patient perspectives after implantation of one of three EDOFs or a monofocal lens (control). They found that recipients of diffractive EDOFs had the most visual disturbances.

    For this prospective, randomized, double-masked study, the researchers evaluated the AcrySof IQ Vivity, AT Lara 829MO, Tecnis Symfony ZXR00, and the monofocal AcrySof IQ SN­60WF. There were 22 patients in each lens group. The variables assessed for each patient at three months postoper­atively included light distortion index (LDI), best-fit circle radius, and self-reported quality of vision according to the McAlinden questionnaire.

    For LDI and best-fit circle radius, there were no differences under mon­ocular conditions between the study groups. However, in the binocular set­ting, significant differences were noted. Patients who received the monofocal lens had better values than those who received the Tecnis Symfony (p = .025 and p = .024, respectively) or the AT Lara (p = .002 for both variables). The results were better with Vivity than with Symfony (p = .015 and p = .014, respectively) or AT Lara (p = 0.001 for both variables). Halos were least common with monofocal lenses: they were absent in 20 of the 22 patients in the monofocal group, 18 in the Vivity group, 13 in the Symfony cohort, and 11 in the AT Lara cohort.

    The two diffractive EDOF lenses in this study (Symfony, AT Lara) induced comparable visual disturbances. Of note, for all parameters, the disturbanc­es were worse than those produced by the nondiffractive EDOF model (Vivi­ty) or the monofocal lens.

    The original article can be found here.