Extended-depth-of-focus IOLs (EDOF): various concepts for same level of performance

Session Details

Session Title: Extended Depth-of-Focus IOL Concepts

Session Date/Time: Monday 24/09/2018 | 08:00-10:30

Paper Time: 08:00

Venue: Room A4

First Author: : A.Nirde FRANCE

Co Author(s): :    B. Cochener                    

Abstract Details

Purpose:

Spectacle independence has now become a frequent request for mature patients with cataract to operate and informed about the advances in optics. EDOF implants make the bet of a comfortable vision for most everyday activities, with less impact on the quality of vision and less demand for emmetropia than multifocal implants. Our objective is to evaluate and compare the visual performance of 3 types of implants with extended depth of field of vision.

Setting:

University Brest hospital – Department of Ophtahlmology – France

Methods:

Prospective, comparative and monocentric study, including 45 patients with a bilateral cataract (OSI scatter index >2) (OQAS®) and wishing to avoid any optical correction. Three groups of 15 patients were compared according to EDOF implant type : Symfony® (AMO) (Gp1), Miniwell® (Cutting Edge) (Gp2) and AT LARA® (Zeiss) (Gp3). Post-operative evaluation : refraction, mono and binocular visual acuity at 40 cm, 60 cm and 4 m, defocus curve, subjective quality of vision via a life questionnaire; contrast sensitivity based on MTF; optical aberrations using Ray tracing.

Results:

In binocular vision, the mean uncorrected visual acuity for each of the group was (in decimal) 0.60/0.54/0.57 at 40 cm, 0.8/0.7/0.77 at 60 cm and 0.95/0.96/0.98 at 4 m; no significant difference. Spectacle independence was achieved respectively in 75/72/71% at 40 cm, 91/88/86% at 60 cm and 4 m. In the 3 groups, a dome defocus curve is noted, illustrating the lengthening of the depth of field without a specific focus. The rate of optical aberrations was < 0.30 micron postoperatively. Nocturnal halos, although not severe, remain the main side effect reported (20-30%), increased by monovision > -0.50 D.

Conclusions:

These new EDOF implants could occupy a prominent place in cataract surgery, with the achievement of satisfactory vision at a distance and in between, while near vision is improved by mini-monovision (-0.50 to -0.75 D) and optimised lighting. Most patients (over 90%) are satisfied (including night vision) and would repeat the operation. This new generation of advanced optics IOLs seem to verify their ability to add intermediate vision and a satisfactory respect for the vision of contrasts. Their position would be that of a compromise between monofocal and multifocal implants.

Financial Disclosure:

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