Comparison of the Visual Performances of Diffractive EDOF Lenses, Bifocal Intraocular Lenses with a 3.5 D Addition and Their Combination

Abstract

Abstract Background: To compare the visual performances of diffractive extended depth of focus (EDOF) lenses, diffractive bifocal intraocular lenses (IOLs) and their combination. Methods: This was a prospective, consecutive observational comparative study. Thirty patients (60 eyes) were included in the binocular Diff-aAY group and received bilateral implantation of diffractive bifocal IOLs (Human Optics Diff-aAY). Twenty-nine patients (58 eyes) in the binocular Symfony group received EDOF lenses (Tecnis Symfony ZXR00). The mix-and-match group included 27 patients who received a Symfony IOL in one eye and Diff-aAY IOL in the other eye. Follow-ups were scheduled at 1 day, 3 days, 2 weeks and 6 months. Visual acuities at different distances were examined at every follow-up. At 6 months, defocus curves, optic path difference (OPD) scans, and questionnaire answers were evaluated. Results: There was no significant difference in binocular UIVA, UNVA, or CDVA among the three groups (P=0.079, 0.147 and 0.696, respectively). The mix-and-match group had a superior SR (P=0.027) and MTF (P<0.001) and an inferior RMS (P<0.001). The binocular Symfony and mix-and-match groupsdemonstrated a smoother defocus curve. The three groups reported the same level of postoperative satisfaction (P=0.141) and spectacle independence (P=0.278). Overall, 70.37% of the mix-and-match group had complete spectacle independence, which was higher than that in the other two study groups. Conclusions: Symfony and Diff-aAY both proved to be remarkable regarding distance, intermediate and near vision. The combination of these two IOLs achieved better objective visual quality and spectacle independence but more subjective dysphotopsia, This provides a new and effective option for patients with high visual quality needs.