Clinical ophthalmology (Auckland, N.Z.) · 2026
Visual and Patient-Reported Outcomes of a Non-Diffractive Extended Depth-of-Focus Intraocular Lens with Micro-Monovision in Eyes with Early Macular Pathology.
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Demircan Elif, Rabinovitch David, Ahmed Iqbal Ike K, Varma Devesh K
Аннотация
PURPOSE: To evaluate visual and patient-reported outcomes after bilateral implantation of a non-diffractive extended depth of focus (EDOF) IOL (AcrySof IQ Vivity, Alcon) in patients with early macular pathology.
DESIGN: Single-site, prospective, non-comparative pilot cohort study.
PATIENTS AND METHODS: The study included 20 patients (40 eyes) undergoing bilateral cataract surgery with at least one eye with early-stage macular pathology, specifically age-related macular degeneration (AREDS category 2) or epiretinal membrane (stage 0). All patients received bilateral implantation of the non-diffractive EDOF IOL targeted for micro-monovision. Primary outcomes were monocular corrected distance visual acuity (CDVA) and distance-corrected intermediate visual acuity (DCIVA) at 3 months. Secondary outcomes included binocular CDVA, DCIVA, and distance-corrected near visual acuity (DCNVA); uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA); refractive outcomes; contrast sensitivity and patient-reported outcomes, including satisfaction and visual disturbances.
RESULTS: At 3 months, median (IQR) monocular CDVA, DCIVA, and DCNVA were 0.00 (0.00-0.10), 0.18 (0.08-0.28), and 0.40 (0.30-0.50) logMAR, respectively. Binocular CDVA, DCIVA, and DCNVA were 0.00 (0.00-0.00), 0.13 (0.08-0.18), and 0.35 (0.22-0.40). Binocular UDVA, UIVA, and UNVA were 0.00 (0.00-0.00), 0.08 (-0.01-0.11), and 0.30 (0.20-0.33) logMAR, respectively. 90% of dominant and 95% of non-dominant eyes were within ±0.50 D of the intended outcome. Photopic contrast sensitivity was within normal range, while mesopic values were near the lower end of normal. Most patients (90%) were satisfied with their vision. Visual disturbances were low in frequency, severity, and bothersomeness, with median Rasch-calibrated scores of 32, 27, and 29, respectively.
CONCLUSION: In patients with early macular pathology, bilateral implantation of a non-diffractive EDOF IOL demonstrated promising distance and intermediate vision, favorable near visual outcomes, and high patient satisfaction with minimal visual disturbances. Larger, prospective, comparative studies are warranted to define candidacy for patients with macular pathology.
DESIGN: Single-site, prospective, non-comparative pilot cohort study.
PATIENTS AND METHODS: The study included 20 patients (40 eyes) undergoing bilateral cataract surgery with at least one eye with early-stage macular pathology, specifically age-related macular degeneration (AREDS category 2) or epiretinal membrane (stage 0). All patients received bilateral implantation of the non-diffractive EDOF IOL targeted for micro-monovision. Primary outcomes were monocular corrected distance visual acuity (CDVA) and distance-corrected intermediate visual acuity (DCIVA) at 3 months. Secondary outcomes included binocular CDVA, DCIVA, and distance-corrected near visual acuity (DCNVA); uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA); refractive outcomes; contrast sensitivity and patient-reported outcomes, including satisfaction and visual disturbances.
RESULTS: At 3 months, median (IQR) monocular CDVA, DCIVA, and DCNVA were 0.00 (0.00-0.10), 0.18 (0.08-0.28), and 0.40 (0.30-0.50) logMAR, respectively. Binocular CDVA, DCIVA, and DCNVA were 0.00 (0.00-0.00), 0.13 (0.08-0.18), and 0.35 (0.22-0.40). Binocular UDVA, UIVA, and UNVA were 0.00 (0.00-0.00), 0.08 (-0.01-0.11), and 0.30 (0.20-0.33) logMAR, respectively. 90% of dominant and 95% of non-dominant eyes were within ±0.50 D of the intended outcome. Photopic contrast sensitivity was within normal range, while mesopic values were near the lower end of normal. Most patients (90%) were satisfied with their vision. Visual disturbances were low in frequency, severity, and bothersomeness, with median Rasch-calibrated scores of 32, 27, and 29, respectively.
CONCLUSION: In patients with early macular pathology, bilateral implantation of a non-diffractive EDOF IOL demonstrated promising distance and intermediate vision, favorable near visual outcomes, and high patient satisfaction with minimal visual disturbances. Larger, prospective, comparative studies are warranted to define candidacy for patients with macular pathology.