Tolerance to Induced Astigmatism With a Monofocal Intraocular Lens Designed to Extend the Depth of Focus

Abstract

Purpose: To determine tolerance to residual astigmatism and visual performance in eyes implanted with a monofocal intraocular lens (IOL) designed to extend the depth of focus (Tecnis Eyhance, DIB00; Johnson & Johnson Vision) compared to eyes implanted with a standard monofocal IOL (Tecnis ZCB00; Johnson & Johnson Vision). Methods: This prospective, observational study enrolled consecutive patients who underwent routine cataract surgery and implantation of either the DIB00 (n = 20) or ZCB00 (n = 20) IOL. Astigmatic defocus was induced with a plus cylinder from +0.50 to +2.00 diopters (D) in 0.50-D steps for each astigmatic orientation (against-the-rule [ATR], with-the-rule [WTR], and oblique). Outcome measures included the comparison of mean visual acuity at each step of defocus, astigmatic defocus curves, and near and intermediate visual acuity. Results: Eyes implanted with the DIB00 demonstrated greater astigmatic tolerance and were more likely to maintain 20/40 or better visual acuity with up to +2.00 D of induced ATR and oblique astigmatism than the ZCB00 IOLs. The DIB00 group showed 1.3 lines better visual acuity at 2.00 D of ATR astigmatic defocus and 1 line better than the ZCB00 group at 1.50 D of oblique astigmatic defocus. Although the distance visual acuity was comparable, near and intermediate visual acuities (both distance-corrected and uncorrected) were better for the DIB00 IOL than for the standard ZCB00 IOL. Conclusions: The monofocal IOL designed to extend the depth of focus (DIB00 group) showed greater tolerance to induced astigmatism in ATR and oblique orientations and superior uncorrected and distance-corrected near and intermediate visual acuity than the standard monofocal IOL of the same IOL platform. [ J Refract Surg . 2023;39(4):222–228.]