Optical and visual quality assessment of an extended depth-of-focus intraocular lens based on spherical aberration of different sign

• Published in: International ophthalmology Vol. 41; no. 3; pp. 1019 - 1032
• Main Authors: Ruiz-Mesa, Ramón, Blanch-Ruiz, Julia, Ruiz-Santos, María, Montés-Micó, Robert
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-03-2021; Springer Nature B.V
• Subjects: Acuity; Binocular vision; Depth of field; Eye (anatomy); Eye lens; Frequency dependence; Intraocular lenses; Medicine; Medicine & Public Health; Ophthalmology; Optical communication; Original Paper; Patient satisfaction; Pupils; Quality assessment; Quality control; Questionnaires; Vision; Visual acuity; Visual discrimination; Defocus curve; Wavefront aberrations; Intraocular lens; EDOF
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-020-01659-z

Purpose
To assess the optical quality and the visual performance of patients implanted with an extended depth-of-focus (EDOF) intraocular lens (IOL).
Methods
Thirty-eight eyes underwent implantation of the Mini WELL Ready EDOF IOL and were evaluated at 3-months postsurgery. Higher-order aberrations (HOAs) and modular transfer function (MTF) were measured at 3- and 5-mm pupils. Binocular uncorrected-distance visual acuity (UDVA) and corrected-distance visual acuity (CDVA), uncorrected-distance intermediate visual acuity (UIVA) and corrected-distance intermediate visual acuity (CDIVA) at 80 cm, and uncorrected-distance near visual acuity (UNVA) and corrected-distance near visual acuity (CDNVA) at 40 cm were obtained. Postoperative refraction, binocular defocus curve, halometry and subjective ad hoc patients’ questionnaire were also evaluated.
Results
HOAs were 0.171 ± 0.046 µm and 0.406 ± 0.137 µm at 3 and 5 mm, respectively. MTFs decreased as the spatial frequency increased being comparable for both pupils. 92.10% of eyes were within ± 1.00D, and the mean postoperative spherical equivalent was − 0.25 ± 0.65D. Mean UDVA, UIVA and UNVA were 0.06 ± 0.12, 0.05 ± 0.10 and 0.26 ± 0.28 logMAR, respectively. Mean CDVA, CDIVA and CDNVA were − 0.01 ± 0.08, 0.06 ± 0.11 and 0.24 ± 0.12 logMAR, respectively. Defocus curve showed a continuous range of vision, especially at intermediate distances. Mean discrimination index was 0.79 ± 0.04. Questionnaire revealed that about 79% of patients reported a high or moderately high satisfaction with the procedure, and about 95% of patients would undergo the same procedure again.
Conclusions
The Mini WELL Ready EDOF IOL provided good optical and visual quality with high level of patient satisfaction and seems to be a valuable option to provide unaided vision at different distances minimizing visual disturbances.