Evaluation of Visual, Refractive, and Functional Outcomes after Implantation of an Extended Depth of Focus Intraocular Lens in Patients with Stable and Mild Glaucoma.

INTRODUCTION

The aim of this study is to describe the visual, refractive, functional, and patients' satisfaction outcomes of the AcrySof™ IQ Vivity™ extended depth-of-focus intraocular lens (EDOF IOL) in patients with mild primary open-angle glaucoma (POAG).

METHODS

This is an ambispective, multicenter, and descriptive study. Patients with mild and stable POAG for at least 6 months, as well as patients who had the AcrySof™ IQ Vivity™ EDOF IOL implanted were included. Humphrey Field Analyzer III (Carl Zeiss Meditec, Dublin, CA, USA) and Triton optical coherence tomography (Topcon, Japan) were used to evaluate the inclusion criteria. In all cases, the formula used to calculate IOL power was Barrett Universal II. Refractive outcomes and visual acuity at distance, intermediate, and near were evaluated from 3 months postoperatively onward. In addition, monocular and binocular defocus curve and contrast sensitivity (CSV-1000, VectorVision, Greenvile, OH, USA) were assessed. Patient satisfaction was assessed through the Intraocular Lens Satisfaction (IOLSAT) and Questionnaire for Visual Disturbances (QUVID) questionnaires .

RESULTS

In total, 72 AcrySof™ IQ Vivity™ lenses from 36 patients were enrolled, of which 28 were women. The mean age was 71.61 ± 7.68 years, the mean thickness of the retinal nerve fiber layer (RNFL) was 79.24 ± 14.96 µm, the mean intraocular pressure (IOP) was 16.88 ± 3.09 mmHg, and the mean number of topical anti-glaucoma medication was 0.89 ± 0.95. Binocular corrected distance visual acuity (CDVA), binocular corrected intermediate visual acuity (CIVA), and binocular corrected near visual acuity (CNVA) were 0.00 ± 0.12, 0.16 ± 0.14, and 0.24 ± 0.11 LogMAR, respectively. Spherical equivalent was -0.27 ± 0.33 diopters (D). In addition, 86.11% of eyes were within ± 0.5 D and 95.83% were within ± 1.0 D. The binocular defocus curve shows a peak of maximum visual acuity (VA) at 0 D (0.00 ± 0.11 LogMAR) and smooth curve at intermediate (66 cm/-1.5 D) 0.11 ± 0.09 LogMAR and near distance (40 cm/-2.5 D) 0.36 ± 0.18 LogMAR. Binocular contrast sensitivity showed a decrease in high spatial frequencies compared with low spatial frequencies. The IOLSAT revealed that in bright light conditions, 88.89%, 91.67%, and 63.89% of patients "never" or "rarely" need glasses at far, arm's length, and near distances, respectively. In addition, according to the QUVID, 97.06% of patients "never" report shadow areas.

CONCLUSIONS

The new AcrySof™ IQ Vivity™ EDOF IOL seems to provide good visual outcomes at distance, intermediate, and near vision, with an adequate contrast sensitivity, defocus curve, a low rate of visual disturbances and high visual satisfaction in patients with mild and stable POAG.