Comparison of Clinical Outcomes After Cataract Surgery with Implantation of Either a Partial-Depth of Field Extended or Monofocal Intraocular Lens

TL;DR

A new intraocular lens improves intermediate and near vision after cataract surgery without compromising distance vision or visual quality.

Contribution

A novel partial-depth-of-field intraocular lens is shown to enhance intermediate and near visual performance compared to monofocal lenses.

Findings

The partial-DOFi IOL showed significantly better distance-corrected intermediate and near visual acuity compared to monofocal IOLs.

Patient-reported outcomes indicated improved performance in daily activities like reading and shopping with the partial-DOFi IOL.

No significant differences were found in distance vision or visual quality between the two IOL types.

Abstract

Background/Objectives: To compare the clinical outcomes following cataract surgery with implantation of a new partial depth of field (DOFi) intraocular lens (IOL) versus a monofocal IOL of identical material, platform, and haptic design. Methods: Single-center, non-randomized trial including 55 patients randomly assigned to be implanted either with the partial-DOFi IOL Tecnis PureSee (partial-DOFi group, 29 patients) or the Tecnis monofocal IOL DCB00/ZCU (both Johnson & Johnson Surgical Vision) (monofocal group, 26 patients). Monocular visual acuity (VA), refractive, binocular defocus curve, and patient-reported outcomes (QoV and Catquest 9SF questionnaires) were evaluated during a 3-month follow-up. Results: No significant differences between monofocal and partial-DOFi groups were found in monocular postoperative uncorrected- (0.03 ± 0.08 vs. 0.05 ± 0.10, p = 0.419) and corrected-distance VA (−0.03 ± 0.04 vs. −0.03 ± 0.05, p = 0.642). Significantly better distance-corrected intermediate VA was found in the partial-DOFi group (0.29 ± 0.08 vs. 0.10 ± 0.06, p < 0.001). Similarly, postoperative monocular distance-corrected near VA was better in the partial-DOFi group (0.51 ± 0.10 vs. 0.31 ± 0.09, p < 0.001). In the defocus curve, significantly better distance-corrected VAs compared to monofocal were found for all defocus levels from −1.50 to −4.00 D. Minor reports of starbursts were found in both IOL groups. With the Catquest questionnaire, some significant differences were found between groups including reduced difficulty reading newspapers (p < 0.001), improved visibility of prices while shopping (p < 0.001) and enhanced performance of hobbies (p = 0.030) and needlework (p < 0.001). Conclusions: The partial-DOFi IOL evaluated demonstrates superior intermediate and near visual performance compared to a monofocal IOL, while maintaining equivalent distance vision and visual quality.

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