Clinical outcomes with a low add multifocal and an extended depth of focus intraocular lenses both implanted with mini-monovision

Abstract

Objectives: To compare the visual acuity, contrast sensitivity (CS), spectacle needs, photic phenomena, and quality of life parameters of patients bilaterally implanted with a low add multifocal (MIOL) or an extended depth of focus (EDOF) intraocular lens (IOL), both with intended mini-monovision.

Methods: In this prospective, randomized, comparative study, patients were randomized to receive either Tecnis +2.75 D (ZKB00) (MIOL Group, n = 15) or Tecnis Symfony (ZXR00) (EDOF Group, n = 14) for bilateral implantation with mini-monovision (-0.50 D). Binocular logMAR uncorrected visual acuities (UVA), monocular defocus curves, CS with CSV 1000-E, and Pelli-Robson Test (PRT), spectacle needs and quality of life parameters with NEI RQL-42 questionnaire were evaluated at postoperative 1, 3, and 6 months.

Results: Results of MIOL and EDOF Groups at postoperative month 6 are as follows: distance (6 m) UVA -0.03 ± 0.05 and -0.05 ± 0.06 (p = 0.938), intermediate (60 cm) UVA, 0.04 ± 0.08 and -0.03 ± 0.07 (p = 0.046); near (40 cm) UVA, 0.22 ± 0.08 and 0.15 ± 0.07 (p = 0.046); near spectacle needs, 26.7% and 14.3% (p > 0.05), respectively. Better visual acuity was achieved in the EDOF Group between the defocus range of -0.50 and -1.75 D (p < 0.05). No significant difference was found regarding photic phenomena and CS evaluated with CSV 1000-E between the two IOL groups at 6 months after surgery (otherwise there are differences at 1 and 3 months in favor of EDOF). However, EDOF Group performed better in mesopic CS evaluated with PRT (p < 0.05).

Conclusions: When implanted with mini-monovision better binocular uncorrected visual performance at intermediate and near distances achieved with EDOF than low add MIOL.

Fig. 1. The cumulative binocular uncorrected logarithm of the minimum angle of resolution (logMAR) visual acuities of patients.

For distance (UDVA), intermediate (UIVA), and near (UNVA) in the MIOL and EDOF Groups 6 months after surgery.

Fig. 2. The defocus curve and change in contrast sensitivity with and without glare over time.

A Mean distance-corrected monocular defocus curves of the patients in the MIOL and EDOF Groups. B Contrast sensitivity with and without glare changes over time in the MIOL and EDOF Groups. D diopters, logMAR logarithm of the minimum angle of the resolution. *p < 0.001, Mann–Whitney U test. ^†p = 0.006, Mann–Whitney U test.