Risk factors associated with visual performance of enhanced monofocal intraocular lens

Abstract

Aims/Purpose: To investigate the ocular parameters that affect visual acuity and quality with an enhanced monofocal intraocular lens (Tecnis Eyhance ICB00 and Tecnis Eyhance Toric DIU).Methods: Patients who underwent cataract surgery with ICB00 or DIU by a single surgeon were included. Prior to surgery, the patients' age, gender, axial length, anterior chamber depth, spherical aberration Z (4,0), vertical coma, horizontal coma, angle κ, angle α and other ocular parameters were investigated. At 1 month after surgery, uncorrected near (40 cm, UNVA), intermediate (66 cm, UIVA) and distance logMAR visual acuity (UDVA), IOL decentration amount and a quality of visual acuity (QoV) questionnaire were conducted.Results: A total of 43 patients with 58 eyes were enrolled in this study. The results of univariate linear regression analyses showed a negative correlation between spherical aberration and logMAR UNVA and UIVA (p = 0.003, β = −0.51 and p = 0.018, β = −0.23, respectively), and a positive correlation between angle α and logMAR UIVA (p = 0.036, β = 0.19). Deeper anterior chamber depth was associated with poorer total QoV (p = 0.018, β = 14.43), particularly in the glare, halo, blurred and fluctuation perception. A higher amount of IOL decenteration showed a tendency to decrease UNVA and UIVA (Pearson correlation coefficient, r = 0.336, r = 0.221), but there was no significant effect on UDVA (Pearson correlation coefficient, r = 0.042).Conclusions: In enhanced monofocal intraocular lenses, a higher level of spherical aberration is associated with better performance in near and intermediate visual acuity, while a larger angle α has a negative impact. A deeper anterior chamber depth negatively effects on the quality of visual acuity. Moreover, as the amount of IOL decentration increases, there is a tendency for a decrease in near and intermediate visual acuity.