Abstract

BackgroundThis study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery.MethodsAll comparative clinical trials that involved bilaterally implanting EDOF IOLs in patients with cataract were retrieved from the literature database. We used random effects models to pool weighted mean differences (WMD) and risk ratio (RR) for continuous and dichotomous variables, respectively.ResultsNine studies with a total of 1336 eyes were identified. The subgroup analysis was conducted according to the type of IOLs used in the control group. Compared with monofocal IOLs, EDOF IOLs produced better uncorrected intermediate visual acuity (WMD: -0.17, 95% CI: − 0.26 to − 0.08, P = 0.0001) and uncorrected near visual acuity (WMD: -0.17, 95% CI: − 0.21 to − 0.12, P < 0.00001). EDOF IOLs resulted in reduced contrast sensitivity, more frequent halos, however, higher spectacle independence (RR: 2.81, 95% CI: 1.06 to 7.46, P = 0.04) than monofocal IOLs. Compared with trifocal IOLs, EDOF IOLs produced worse near visual acuity (MD: 0.10, 95% CI: 0.07 to 0.13, P < 0.0001). EDOF IOLs performed better than trifocal IOls in contrast sensitivity, and there were no significant difference in halos and spectacle independence. Serious postoperative complications were rare, with no adverse events were reported in most studies.ConclusionsIncreasing the risk of contrast reduction and more frequent halos, EDOF IOLs provided better intermediate and near VAs than monofocal IOLs. At the expense of near vision, patients receiving EDOF IOLs have better contrast sensitivity than those receiving trifocal IOLs. Halo incidence and spectacle independence of EDOF IOLs were similar to those of trifocal IOLs.

Highlights

  • This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery

  • Compared with monofocal IOLs, EDOF IOLs provided comparable uncorrected distance visual acuity (UDVA) (WMD: 0.01, 95% confidence interval (CI): − 0.06 to 0.08, P = 0.81), better uncorrected intermediate visual acuity (UIVA) (WMD: -0.17, 95% CI: − 0.26 to − 0.08, P = 0.0001) and better uncorrected near visual acuity (UNVA) (WMD: -0.17, 95% CI: − 0.21 to − 0.12, P < 0.00001)

  • This systematic review revealed the unique features of EDOF IOLs when compared with other types of IOLs

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Summary

Introduction

This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery. With a single focal point, monofocal IOLs are effective in restoring satisfactory distance vision; most patients require spectacle correction for intermediate and near vision, even after surgery [1, 2]. Multifocal IOLs were designed to meet the increasing demand from patients for spectacle independence [3]. A new-concept IOL was introduced based on extended depth of focus (EDOF) technology [5]. The basic principle behind EDOF IOLs is to create a single elongated focal point to enhance the depth of focus or range of vision [6]. A proprietary diffractive echelette design is used in EDOF IOLs and forms a step structure.

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