Extended Depth Of Field Research Articles

Tolerance to induced astigmatism of patients with trifocal or extended depth of focus intraocular lens implantation.

Residual astigmatism is common after cataract surgery involving implantation of an intraocular lens, yet the tolerance of presbyopia-correcting intraocular lens to astigmatism of different magnitudes and axes is poorly understood. Here we compared visual acuity and quality in the presence of induced astigmatism after implantation of a trifocal or extended-depth-of-focus (EDOF) intraocular lens, the two widely used presbyopia-correcting intraocular lenses. At least 3 months after implantation of a TFNT00 or ZXR00 intraocular lens, patients were analyzed by slit-lamp examination, non-contact tonometry, subjective refraction, iTrace aberrometry, and corneal topography. After correction of residual astigmatism, astigmatism of different magnitudes on different axes was induced using cylindrical lenses, and overall visual acuity was measured, while objective visual quality was measured using the Optical Quality Analysis System II. Subjects were also asked about subjective visual quality using the Visual Function-14 questionnaire. Comparison of 18 individuals who received a trifocal lens and 19 who received an EDOF lens showed that objective visual quality was better in the EDOF group regardless of the magnitude or axis of the induced astigmatism. In both groups, astigmatism of at least -1.00 DC influenced distant vision more severely when the axis was 45° than 0° or 90°, meanwhile astigmatism of at least -1.50 DC influenced near and intermediate vision more severely when the axis was 45° than 0° or 90°. Trifocal or EDOF intraocular lenses are less tolerant of oblique astigmatism than astigmatism with or against the rule. EDOF lenses may provide better objective visual quality than trifocal lenses in the presence of astigmatism, regardless of its magnitude or axis.

Using adaptive optics to optimize the spherical aberration of eyes implanted with EDOF and enhanced monofocal intraocular lenses.

To assess the effect of change in ocular spherical aberration (SA) with adaptive optics on visual acuity (VA) at different defocus after implantation of extended depth-of-focus (EDOF) and enhanced monofocal intraocular lenses (IOLs). Narayana Nethralaya Eye Hospital, Bangalore, India. Prospective, longitudinal, observational. 80 eyes (40 patients) that had cataract surgery were included in the study. 40 eyes were implanted with Eyhance EDOF IOLs and the remaining with Vivity EDOF IOLs. Baseline ocular aberrations were measured with a visual adaptive optics aberrometer, then the optimal SA was determined by increasing it in steps of -0.01 μm up to -0.1 μm until the maximum improvement in near distance VA was observed for a given eye. Then the defocus curve for each eye was measured after modifying the ocular SA by magnitude equal to optimal SA. Most of the eyes accepted a negative induced SA of -0.05 μm (Eyhance group: 67.6%; Vivity group, 45.2%). In the Eyhance group (dominant eyes), VA improved at -2 diopters (D) ( P < .02) only and degraded at 0 D, +0.5 D, and +1 D defocus ( P < .05). In the Vivity group, the VA remained unchanged at all defocus ( P > .05). In the Eyhance group (nondominant eyes), VA improved at -3.5 D defocus only and degraded at +1.5 D and +2 D defocus ( P < .05). In the Vivity group, VA improved at -2.5 D defocus ( P < .05) only. A negative induced SA of -0.05 μm in implanted eyes was optimal for a slight improvement in distance-corrected near and intermediate VA without any significant decrease in baseline distance-corrected VA.

Effect of spherical aberration on visual acuity and depth of focus in pseudophakic eyes.

To assess the performance of 4 intraocular lenses (IOLs) in various spherical aberration (SA) conditions, using the VAO adaptive optics simulator. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. Prospective case series. Distance-corrected visual acuities at distance (CDVA), intermediate (DCIVA), and near (DCNVA) were measured in 42 dilated pseudophakic eyes at baseline and with ocular SA ranging from -0.4 to +0.4 μm in increments of 0.2 μm (6.0-mm pupil). 4 IOL types were assessed: monofocal IOLs with zero-SA, enhanced-monofocal, extended depth-of-focus (EDOF), and continuous range-of-vision. Compared with SA = 0 μm, significant changes (all P < .05) were: (1) zero-SA monofocal IOLs' DCNVA at high contrast improved by 0.13 logMAR with SA = -0.4 μm and worsened by 0.09 and 0.10 logMAR with SA = +0.2 and +0.4 μm, respectively. DCNVA at low contrast worsened by 0.09 logMAR with SA = +0.4 μm; and (2) with SA = -0.4 μm, the enhanced monofocal IOL lost 0.06 logMAR of CDVA at high contrast and gained 0.09 logMAR of DCNVA at low contrast. There were no significant changes from SA = 0 μm for EDOF and continuous range-of-vision IOLs. Zero-SA and EDOF IOLs were the most and least sensitive to SA modulation, respectively. In perfect optical systems where all the optical elements are aligned, induction of targeted amounts of negative SA improved the depth of focus of some IOL types. No benefit was found with positive SA.

Positive dysphotopsia after implantation of an EDOF intraocular lens

Introduction: This report describes a case of positive dysphotopsia (PD) after refractive lens exchange (RLE) with implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL). Patient and Clinical Findings: A healthy 48-year-old man underwent RLE with bilateral implantation of a nontoric EDOF IOL and suffered from monocular triplopia in both eyes. The visual acuity was suboptimal with an uncorrected distance visual acuity of 20/25 in the right eye and 20/30 in the left eye. Diagnosis, Intervention and Outcomes: Slitlamp examination showed well-centered implanted IOLs, without capsular distension syndrome. Bilateral IOL exchange was performed with an aspheric monofocal IOL with a 7.0 mm optic diameter, which diminished the PD complaints. Conclusions: This case report describes disturbing PD after bilateral implantation of an EDOF IOL. Exchange of these EDOF IOLs with a larger optical diameter monofocal IOL resulted in resolution of symptoms.

First experience of implantation of extended depth of focus intraocular lenses in patients with glaucoma

This study evaluates the effectiveness of implantation of extended depth of focus (EDOF) intraocular lenses (IOL) in patients with cataract and glaucoma. The study included 13 patients (16 eyes) who underwent implantation of the Lentis Comfort EDOF IOL (Teleon Surgical BV, Netherlands). Standard phacoemulsification cataract surgery with IOL implantation was performed in a planned manner after the hypotensive surgery stage in two eyes; a combined procedure was performed in 14 cases. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), near visual acuity, and intraocular pressure (IOP) measured with a Maklakov tonometer were assessed preoperatively, on the first day, and 3-6 months after surgery. Computer perimetry using the 30-2 program and spatial contrast sensitivity (SCS) assessment were also performed preoperatively and at the same follow-up time points. On the first day after surgery, UCVA was 0.53±0.65, BCVA was 0.85±0.45. Near UCVA (at 40 cm) was 0.5±0.14 on the first day after surgery and 0.56±0.18 at 3-6 months. According to computer perimetry data, retinal light sensitivity values increased in all patients in the long-term (-3.1±2.9 dB). SCS values increased for objects of all sizes compared to preoperative values. Implantation of EDOF IOL contributes to improved vision without reducing contrast sensitivity and retinal light sensitivity in patients with concomitant cataract and glaucoma.

My Experience of Extended Depth of Focus Intraocular Lens Implantation

Aim: This research was conducted to determine whether or not a recently formulated intraocular lens (IOL) with an extended depth of focus (EDOF) successfully treats cataracts. Different Techniques: After performing phacoemulsification cataract surgery on a total of 36 eyes belonging to 25 patients ranging in age from 51 to 82, the LUCIDIS EDOF IOL, which was produced by SAV-IOL SA and is situated at Route des Falaises 74 in Neuchatel, Switzerland, was successfully implanted. The patients' ages ranged from 51 to 82. SAV-IOL SA, located at 74 Route des Falaises in Neuchatel, Switzerland, served as the location for the surgical procedure. Switzerland is home to the city in question. During the course of the three-month follow-up period, the patients' uncorrected near vision (UNVA), distance-corrected near vision (DCNVA), uncorrected and corrected distance vision (UDVA and CDVA), monocular defocus curves, and refractive outcomes were evaluated. Result: "The postoperative mean values for UDVA, UNVA, and DCNVA were 0.10 \(\pm\) 0.19, 0.16 \(\pm\) 0.24, and 0.39 \(\pm\) 0.38, respectively. The average distance-corrected visual acuity was over 0.30 between +1.02 and 1.52 D defocus. After cataract surgery, the Synthesis + EDOF IOL provides functional far, intermediate, and close vision. A micro-monovision method might boost this new IOL's near-visual performance. Clinical investigations should confirm this pilot study's findings.

COMPARISON OF STEREOLOGY METHODS FOR ASSESSING AGE-RELATED EFFECTS ON IMMUNOSTAINED BRAIN CELLS

Abstract The primary benefit of stereology methods is quantification of well-stained biological objects in tissue sections with the ability to adjust sampling intensity to achieve desired levels of precision. The advent of hand-crafted algorithms and artificial intelligence-based deep learning (DL) provides an opportunity for more standardized collection of stereology data with enhanced efficiency and higher reproducibility compared to state-of-the-art manual stereology. We contrasted and compared the performance of four manual, semi-automatic, and fully automatic approaches for generating data for total number of Neu-N immunostained neurons in neocortex (NCTX) in the mouse brain. The gold standard for these studies was manual counts using the state-of-the-art optical fractionator method on 3-D reconstructed serial z-axis image stacks through a known tissue volume (disector stacks). To allow for direct methodological comparisons on the same images, disector stacks were automatically converted into extended depth of field (EDF) images in which all neurons in the disector stack were imaged at each cell’s maximal plane of focus. Total number of Neu-N neurons on the same EDF images were counted by a fully automatic hand-crafted method [automatic segmentation algorithm (ASA)] and a semi-automatic method [ASA counts manually corrected for false positives and negatives]. All comparison counts were done using unbiased frames and counting rules with total counts of NeuN-immunostained neurons by the optical fractionator method. The results were comparable across methods with wide variations in throughput efficiency and inter-rater agreement. These results are discussed with respect to applications to experimental studies of brain aging, neuroinflammation and neurodegenerative disease.

Millimeter-wave metalens with extended depth of focal on the short focal length

Millimeter wave (mm-wave) metalens has shown significant progress in recent years. However, the existing works in the literature on the extended depth of focal (EDOF) metalens present limitations for mm-waves. More specifically, the good performance of the EDOF requires a focal length larger than the radius of the metalens, which limits its miniaturization applications. In this work, mm-wave metalens with EDOF on the short focal length was proposed. The focus distribution was equally divided and the spin Hall effect was employed to guarantee the uniform focus intensity. From our analysis, it was demonstrated that the designed metalens can work at mm-wave frequencies and also achieve extended focal depth at half the metalens’ radius. The proposed metalens has the unique characteristics of short focal length (The focal diameter ratio is 0.36) with EDOF. Moreover, it can be used in the mm-wave field for short-distance imaging and detection, also the development of high-power metalens applications may be facilitated.

An evaluation of the RapidHIT™ ID system for hair roots stained with Diamond™ Nucleic Acid Dye

The RapidHIT™ ID (RHID) system was evaluated for its suitability in processing a single hair root to obtain informative DNA profiles. Hair samples were assessed for nuclear DNA prior to DNA analysis using Diamond™ Nucleic Acid Dye (DD) and real-time Extended Depth of Field (EDF) imaging to visualise and count nuclei if present. Hairs were viewed under an Optico N300F LED Fluorescent Microscope and imaged using a MIchrome 5 Pro camera. Hair roots were processed through both the ACE GlobalFiler™ Express sample cartridge and the RapidINTEL™ sample cartridge. A total of 44 hairs including shed hairs (9) and plucked hairs (35) from 8 donors were evaluated in this study. The processing of hairs using the RHID system required the modification of a standard swab that allowed for hairs to be easily collected and placed into the cartridge but also allowed for the re-collection of hair roots post RHID analysis (for potential standard DNA workflow). 90% of plucked hairs with a high nuclei count (>100) resulted in a high partial or full DNA profile, with the remaining 10% resulting in a low partial profile. 44% of shed hairs resulted in a low partial profile, with the remaining hairs resulting in a null profile. This study demonstrated that the RHID system could successfully obtain a DNA profile from a single hair root with nuclei present post-DD staining. According to these results, it is suggested that when dealing with hairs containing fewer than 50 nuclei, using the RapidINTEL™ cartridge can enhance allele recovery.

Clinical outcomes with a novel extended depth of focus intraocular lens Tecnis Symfony

Relevance. Some of the most current intraocular lenses (IOL) are lenses with an extended depth of focus. Lenses of this type allow you to reduce dependence on glasses by distributing light energy to long-range and focus at medium distance, without losing the quality of vision. Studies that analyze the results of implantation of this type of lens are few. Purpose: to evaluate the clinical outcomes of extended depth of focus (EDOF) intraocular lens (IOL) implantation. Materials and methods. Prospective randomized study enrolled 61 patients of 79 eyes (18 to 86 years) undergone uncomplicated phacoemulsifi cation with EDOF IOL Tecnis Symfony (USA) implantation. The study was conducted from November 2020 through November 2022. Uncorrected near visual acuity (UNVA); corrected near visual acuity (CNVA) and uncorrected and corrected distance visual acuity (UDVA and CDVA), monocular defocus curve and refractive outcomes were evaluated during a 3-month period. When calculating the IOL, the target spherical equivalent was –0.35 ± 0.11 D. Results. In the postoperative period 3 months, visual acuity were 0.7 or better in 82.4% UCDVA, 100% CDVA and 50% UCNVA. 3 months after surgery, UDVA and UNVA at 40 cm averaged 0.85 ± 0.15 and 0.69 ± 0.18, respectively. CDVA and CNVA at 40 cm was 0.98 ± 0.04 and 0.8 ± 0.14, respectively. A total of 85.7% of eyes achieved postoperative visual acuity about 0.5 for the range of defocus levels between +1.00 and −1.50 D. Conclusions. Cataract surgery with Tecnis Symfony EDOF IOL implantation provide functional levels of visual acuity in distance, intermediate zones. The near visual performance with this IOL might be signifi cantly enhanced using a micro-monovision approach

Effect of myopia management contact lens design on accommodative microfluctuations and eye movements during reading

BackgroundSoft contact lenses have been developed and licensed for reducing myopia progression. These lenses have different designs, such as extended depth of focus (EDOF) and dual focus (DF). In this prospective, double-masked, cross-over study, different lens designs were investigated to see whether these had impact on accommodative microfluctuations and eye movements during reading. MethodsParticipants were fitted with three lenses in a randomised order; a single vision (SV) design (Omafilcon A2; Proclear), a DF design (Omafilcon A2; MiSight), and an EDOF lens design (Etafilcon A; NaturalVue),. Accommodative microfluctuations were measured at 25 cm for at least 60s in each lens, using a Shin-Nippon SRW-5000 autorefractor adapted to continuously record accommodation at 22Hz. Eye movement data was collected with the Thomson Clinical Eye Tracker incorporating a Tobii Eye bar. Eye movements include fixations per row, fixations per minute, mean regressions per row, total number of regressions, and total rightward saccades. Accommodation data was analysed using power spectrum analysis. Differences between the lenses were compared using a related sample two-way Friedman test. ResultsTwenty-three participants (18–29 years) were recruited to take part. The average mean spherical error was −2.65D ± 1.42DS, with an average age of 23.4 ± 3.5 years. No significant difference for accommodative microfluctuations was found. Significant differences were found for fixations per row (P = 0.03), fixations per minute (P = 0.008), mean regressions per row (P = 0.002), and total number of regressions (P = 0.002), but not total rightward saccades (P = 0.10). Post-hoc analysis indicated the EDOF lens results were significantly different from the other lenses, with more regressive eye movements observed. ConclusionsRegressive saccades appear to increase when wearing EDOF lens designs, which may impact visual comfort. Further studies in children, over a longer period of adaptation are necessary to assess the potential impact of this finding on daily reading activities in children.

Unilateral intraindividual comparison and bilateral performance of a monofocal spherical and diffractive extended depth of field intraocular lens mix-and-match approach.

To evaluate the intraindividual visual performance of a spherical and extended depth of field (EDOF) IOL used in a mix-and-match approach. Single centre (tertiary care centre), retrospective consecutive case series. Included patients had uneventful cataract surgery with implantation of a spherical monofocal IOL (CT Spheris 204) in the dominant eye and a diffractive EDOF IOL (AT LARA 829) in the non-dominant eye. Monocular and binocular defocus curves and visual acuity at various distances were assessed. In addition, binocular reading speed, contrast sensitivity, and patient satisfaction using QOV, Catquest 9SF, and glare/halo questionnaires are reported. A total of 29 patients (58 eyes) were included. We observed significant intra-individual differences for monocular DCIVA, DCNVA, UIVA, and UNVA. There were no differences in monocular BCDVA or UDVA. The monocular defocus curves for the two IOLs significantly differed at defocus steps between -1.0 and -3.5 D. 93.10% of patients reported they would opt for the same combination of IOLs. Excellent uncorrected and corrected distance visual acuity was demonstrated in both groups. The mix-and-match approach described in this study yielded good intermediate vision and improved near vision with high-patient satisfaction.

Comparative Evaluation of Visual Performance and Patient Satisfaction following Cataract Surgery: A Retrospective Analysis of an Extended Depth-of-Focus Intraocular Lens and a Diffractive Multifocal Lens with Extended Depth of Focus

(1) Background: Cataract surgery has evolved significantly with the development of multifocal and extended depth-of-focus intraocular lenses (IOLs), driven by increasing patient desire for spectacle independence. (2) Methods: This retrospective, single-center study conducted on 86 eyes from 59 patients aged 40–80 years compared the performance and patient satisfaction of Symfony® and Synergy® (Johnson &amp; Johnson Vision) IOLs during a follow-up of 1 year postsurgery. Uncorrected and corrected distance, intermediate, and near visual acuities were assessed (UDVA, CDVA, UIVA, CIVA, UNVA, and CNVA, respectively). (3) Results: Although both IOLs demonstrated a commendable distance VA, Synergy® outperformed in near VA (UNVA, p = 0.040; CNVA, p = 0.014), and Symfony® slightly excelled in intermediate VA (UIVA, p = 0.014; CIVA, p = 0.040). The defocus curve of Synergy® maintained a higher VA even at −4 D with a smoother curve and a broad landing zone. Although the optical quality assessments were similar, Symfony® had a nonsignificant edge. Patients indicated higher satisfaction and reduced reliance on spectacles with Synergy® despite more frequent reports of glare and halos. (4) Conclusions: These findings highlight the importance of personalized IOL selection in cataract surgery, which must be customized to apply the distinctive advantages of each IOL to address the unique visual requirements and lifestyle of patients.

Comparison of bilateral implantation of an extended depth of focus lenses and a blend approach of extended depth of focus lenses and bifocal lenses in cataract patients

BackgroundTo compare the visual outcomes, spectacle independent rate and stereopsis in patients who underwent bilateral implantation of extended depth of focus (EDOF) intraocular lens (IOL), or a blend approach of EDOF and bifocal IOL.MethodsA total of 60 cataract patients, who were scheduled for phacoemulsification and intraocular lens implantation in both eyes in West China Hospital of Sichuan University, were enrolled and divided into Micro monovision group(-0.5D~-1.0D), Non-micro monovision group (< 0.5D) with Symfony IOL, and Mixed group with Symfony and ZMB00 IOLs. Three months postoperatively, we compared the visual acuity, modulation transfer function (MTF), defocus curve, stereopsis, spectacle independence, and photic phenomena among the three groups.ResultsCompared to the Non-micro monovision group (UNVA: 0.07 ± 0.04), Micro monovision group (UNVA: 0.00 ± 0.07, P < 0.001) and Mixed group (UNVA: -0.02 ± 0.06, P < 0.001) showed improvement in binocular uncorrected near visual acuity (UNVA). Additionally, Mixed group exhibited lower MTF10 (MTF10: 0.38 ± 0.24) and point spread function (PSF: 0.192 ± 0.269) results in their non-dominant eye compared to both Micro monovision group (MTF10: 0.56 ± 0.21, P = 0.027; PSF: 0.417 ± 0.282, P = 0.034) and Non-micro monovision group (MTF10: 0.55 ± 0.19, P = 0.038; PSF: 0.408 ± 0.285, P = 0.003). Spectacle independence for near vision were higher in both the Micro monovision (45%) and Mixed (55%) group compared to the Non-micro monovision group (40%). The Mixed group also reported higher incidence of photic phenomena (25%). However, there were no significant differences in stereoscopic function among the three groups.ConclusionBoth micro monovision and mix-and-match methods can help patients to obtain better visual outcomes at different distances. Mix-and-match method has better near visual acuity, while micro monovision method has better intermediate visual acuity. Non-micro monovision methods will affect patients’ near vision outcomes. Binocularly implanted EDOF IOL has better contrast sensitivity.Clinical trial registrationRegistration date:11/07/2023. Trial registration number: ChiCTR2300073433. Trial registry: West China Hospital of Sichuan University retrospectively registered.

Refractive extended depth-of-focus lens design based on periodic power profile for presbyopia correction.

Limitations of existing diffractive multifocal designs for presbyopia correction include discrete foci and photic phenomena such as halos and glare. This study aimed to explore a methodology for developing refractive extended depth-of-focus (EDoF) lenses based on a periodic power profile. The proposed design technique employed an optical power profile that periodically alternated between far, intermediate and near distances across the pupil radius. To evaluate the lens designs, optical bench testing was conducted. The impact on visual performance was assessed using a spatial light modulator-based adaptive optics vision simulator in human subjects. Additionally, the effects of pupil size change and lens decentration on retinal image quality were examined. A comparative performance analysis was carried out against a typical diffractive trifocal design and a monofocal lens. The proposed design method was found to be effective in uniformly distributing light energy across all object distances within the desired depth of focus (DoF). While trade-offs between overall image quality and DoF still exist, the EDoF lens design, when tested in human subjects, provided a continuous DoF spanning over 2.25 D. The results also revealed that the EDoF design had a slightly higher dependence on changes in pupil size and lens decentration than the diffractive trifocal design. The proposed design method showed significant potential as an approach for developing refractive EDoF ophthalmic lenses. These lenses offer a continuous DoF but are slightly more susceptible to variations in pupil size and decentration compared with the diffractive trifocal design.

Comparative evaluation of the clinical performance of conventional and extended depth of focus monofocal intraocular lenses (systematic review)

A systematic review was performed in PubMed using the following keywords monofocal IOLs, monofocal IOLs with extended depth of focus (sharpness), EDOF, cataract phacoemulsification, visual acuity, and quality of life. Studies were selected in accordance with the criteria for prospective or retrospective studies. In a comparative analysis of clinical efficacy, the results of binocular IOL implantation and lens material from the same manufacturer were analyzed as the main sources. In total, 234 studies were analyzed using systematic review filters and authors knowledge of the topic. The duration of the retrospective analysis was 8 years (20172023). A total of 234 papers were analyzed over the last 8 years (20172023), further using systematic review filters and the authors knowledge of the topic.&#x0D; Data obtained indicated that traditional monofocal IOLs acted like bifocal lenses because they formed two main focal points for far and near vision, which did not provide the required level of visual acuity at an intermediate distance. The basic optical principle of EDOF (extended depth of focus) was to create a focal point for distance vision and an elongated focal point to increase the depth of field near and at intermediate distances. The results of the literature analysis indicated that the use of EDOF (compared with monofocal IOL) was associated with a higher level of visual acuity at intermediate and near distances and comparable distance visual acuity and increased depth of field, which generally provides a more natural range of vision and less use of glasses. Light phenomena, spectacle independence, and patient satisfaction were comparable among EDOF types.&#x0D; Given the above advantages, EDOF implantation can be considered a variant of an individual approach to the selection of IOLs, taking into account the possibility of using it in patients whose professional activity is associated with long-term visual work at intermediate distances (e.g., users of personal computers). In the context of the role and place of EDOF in the general system of aphakia correction following cataract phacoemulsification, further accumulation of clinical material is necessary, taking into account the IOL model and patients professional visual activity level.

Clinical Performance of Extended Depth of Focus (EDOF) Intraocular Lenses – preliminaryresults

Purpose: Extended depth of focus (EDOF) lenses are the bridge that connects monofocal IOLs to IOLs with multifocal designs. This retrospective study aimed to analyze visual outcomes 3 months after bilateral implantation of the new EDOF intraocular lens in routine cataract surgery. Methods: Visual function was evaluated for near, intermediate, and far distance in 12 patients (24 eyes), bilaterally implanted with an EDOF artificial intraocular lens (IOL). Visual acuity at distance (5m), intermediate (70 cm) and near distance (40 cm) with and without refractive correction was measured. Subjective outcomes regarding visual function, independence from glasses and lighting, presence of light phenomena such as dysphotopsia, and overall patient satisfaction three months after phacoemulsification were also evaluated. Results: The mean age of the patients was 68 years. The mean IOL power was 21.5 ± 2.50 D. Three months after surgery, the mean uncorrected distance (UCDVA), intermediate (UCIVA) and near (UCNVA) visual acuities were 0,9, 0,9 and 0,8. Patient satisfaction was high, with a low occurrence of dysphotopsia. Conclusion: The EDOF IOLs showed satisfactory visual performance after cataract surgery, with high patient satisfaction and a low occurrence of visual disturbances. It resulted in good distance and intermediate vision, but might require spectacles for small print at a near distance.

Computational simulation of the optical performance of an EDOF intraocular lens in post-LASIK eyes.

To evaluate computationally the optical performance of AcrySof IQ Vivity extended depth-of-focus (EDOF) intraocular lenses (IOLs) in post-laser in situ keratomileusis (LASIK) eyes. Visual Optics and Biophotonics Laboratory, Madrid, Spain. Experimental study. Computer pseudophakic eye models were implemented using reported post-LASIK corneal aberrations (refractive corrections from -7.5 to +4.5 diopters [D]) and virtually implanted with monofocal (AcrySof IQ) or EDOF (AcrySof IQ Vivity) IOLs. Retinal image quality was quantified through visual Strehl (VS). The depth of focus (DOF) was calculated from the through-focus VS curves. Halos were estimated from the light spread in the image of a pinhole. Those quantitative parameters were obtained for 5.0 and 3.0 mm pupil diameters. Simulated virgin eyes showed VS of 0.89/0.99 with monofocal IOLs and 0.74/0.52 with EDOF IOLs for 5.0/3.0 mm pupils at best focus. VS decreased with induced spherical aberration (SA) by 25% and with induced SA + coma by 61% on average (3.0 mm pupils). The DOF was 2.50 D in virgin eyes with EDOF IOLs, 1.66 ± 0.30 and 2.54 ± 0.31 D ( P < .05) on average in post-LASIK eyes for 3.0 mm pupils, monofocal and EDOF IOLs, respectively. Halos were more sensitive to SA induction for 5.0 mm pupils, and induction of positive SA (myopic LASIK) resulted in reduced halos with the EDOF when compared with the monofocal IOLs, by 1.62 (SA) and 1.86 arc min (SA + coma), on average. Computer post-LASIK pseudophakic eye models showed that the DOF was less dependent on the presence of SA and coma with EDOF IOLs and that halos were reduced with EDOF IOLs compared with the monofocal IOL for a range of SA.

Refractive Predictability of a Swept Source Optical Coherence Tomography Biometer in Long and Short Eyes Implanted with Extended Depth of Focus Intraocular Lenses.

To determine the refractive predictability of Argos (Movu, a Santec company) measurements and the Barrett Universal II formula in long and short eyes implanted with an extended depth of focus (EDOF) intraocular lens (IOL). This retrospective, non-interventional study included 86 eyes (55 long and 31 short) of 55 patients. Preoperative biometry was performed using the Argos. Preoperative IOL power formulas were the preprogrammed Barrett Universal II (BUII). Data were collected for refractive outcomes, postoperative prediction error (directional and absolute), and monocular corrected distance visual acuity (CDVA, Snellen). The mean absolute prediction error for BUII was 0.27 ± 0.26 D overall, 0.24 ± 0.20 D in long eyes, and 0.33 ± 0.33 D in short eyes. Overall, the percentage of eyes with ≤ 0.5 D prediction error was 84% for BUII. In long eyes, the percentage of eyes with ≤ 0.5 D prediction error was 90% for BUII. In short eyes, the percentage of eyes with ≤ 0.5 D prediction error was 74% for BUII. The percentage of eyes with ≤ 0.5 D of MRSE was 89% for long eyes and 94% for short eyes. Visual acuities were excellent in both long and short eyes, with > 90% of eyes 20/25 or better in each group. The prediction error of Argos using BUII was low in long and short eyes at one month after EDOF IOL implantation.

Medical and technical aspects of using intraocular lenses with extended depth of field

Purpose: to analyse the medical and technical aspects of intraocular lenses (IOLs) with extended depth of field (EDOF). Literature analysis was performed in the PubMed international database, the search keywords being “IOL with extended depth of field” (EDOF), “Optical Bench Evaluation of IOL”, “Preclinical evaluation of IOL”, “Aberrations”, “Monofocal IOL” (MOFIOL), “Multifocal IOLs” (MUFIOL). A total of 226 sources were analyzed, further using systematic review filters and the authors' knowledge of the topic. The duration of the retrospective analysis was 7 years (2016–2022), some of the considered work dates back to 2023. Unlike MUFIOL, EDOF lenses create a single elongated focal point to increase the depth of field, rather than several foci. Thus, EDOFs are aimed at reducing light phenomena, glare and halos, the occurrence of which is characteristic of MUFIOL. A potential disadvantage of EDOF is the reduction in retinal image quality with an excessive increase in the number of aberrations. The factors of the medical and technical assessment of the IOL indicate a high correlation with the predicted visual acuity (VA). EDOFs, whose design features are based on a higher order aspherical design, provide comparable optical quality for the far and extended intermediate ranges, while producing halo effects comparable to those of MOFIOL. Designed to improve depth of field with a full correction of corneal spherical aberration, EDOF provides intermediate-level pupil-independent improvement in VA and maintains visual acuity unlike conventional MOFIOLs. The quality of visual perception and the predicted VA of various types of EDOFs depend on the optical technology and the correction of corneal spherical aberrations. EDOFs can be expected to provide adequate vision at an intermediate distance (with a possibility of insufficient near vision). At the same time, the expansion of the depth of field varies between models, which should be taken into account when preoperatively choosing EDOF for a specific type of daily visual activity of the patient, especially for people with visually strenuous work. The results of the medical and technical assessment are widely used in the clinical testing of specific types of EDOF IOLs.