A Comparative Evaluation of Visual, Refractive, and Patient-Reported Outcomes of Three Extended Depth of Focus (EDOF) Intraocular Lenses

Clin Ophthalmol. 2020 Aug 20:14:2339-2351. doi: 10.2147/OPTH.S255285. eCollection 2020.


Objective: To compare visual, refractive, and patient-reported outcomes of patients implanted with one of three types of extended depth of focus (EDOF) intraocular lenses.

Setting: Asian Eye Institute, Philippines.

Design: Retrospective cohort study.

Methods: Subjects implanted with Symfony (Johnson and Johnson, USA), IC-8 (AcuFocus, USA), and WIOL (Medicem, Czech Republic) EDOF intraocular lenses were recruited. Spherical equivalent, uncorrected and corrected visual acuity, defocus curve, and modulation-transfer function, Strehl ratio, and visual Strehl optical transfer function values, photic phenomena, and questionnaire answers were measured and assessed.

Results: A total of 32 eyes with the Symfony lens, 30 with the IC-8 lens, and 32 with the WIOL lens were included in the study. Mean postoperative spherical equivalent was -0.24 D for the Symfony, -0.17 D for the IC-8, and 0.27 D for WIOL. There were no significant differences in postoperative monocular and binocular uncorrected and corrected visual acuity. On a monocular defocus curve, the IC-8 and Symfony showed significantly better vision than WIOL. The Symfony had significantly better modulation-transfer function, Strehl ratio, and visual Strehl optical transfer function. No difference was seen among the three lenses with regard to glare or starburst, while patient satisfaction remained high in all groups for far, intermediate, and near vision.

Conclusion: All eyes implanted with the three EDOF designs achieved excellent far and intermediate vision, with acceptable near vision. The IC-8 and Symfony exhibited a better range of vision on defocus-curve testing. The Symfony showed superior results in quality of vision. Patient satisfaction was high in all three EDOF groups.

Keywords: EDOF; IC-8; Symfony; WIOL; diffractive echelette; small aperture.