Bifocal nondiffractive intraocular lens for enhanced depth of focus in correcting presbyopia: Clinical evaluation

PURPOSE: To assess the clinical outcomes and patient satisfaction after bilateral cataract surgery with implantation of a bifocal refractive enhanced depth of focus intraocular lens (IOL) with a low near addition (add). SETTING: Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany. DESIGN: Prospective longitudinal case series. METHODS: Eyes with bilateral age-related cataract and corneal astigmatism of less than 1.0 diopter (D) had standard microincision cataract surgery with implantation of a bifocal nondiffractive shape-segmented enhanced depth of focus IOL (Lentis Comfort, LS-313 MF15). The corrected and uncorrected (UDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, defocus, corneal astigmatism, spectacle independence, contrast sensitivity, rotational stability, photic phenomena, and patient satisfaction were evaluated over a 3-month follow-up. RESULTS: The study comprised 22 patients (44 eyes). The mean postoperative manifest spherical equivalent was -0.10 D ± 0.58 (SD), resulting in a mean UDVA of 0.07 ± 0.10 logMAR, mean UIVA of 0.21 ± 0.15 logarithm of minimum angle of resolution (logMAR), and mean UNVA of 0.53 ± 0.15 logMAR. Binocular UDVA was 0.01 ± 0.08 logMAR. The best reading distance was 0.46 ± 0.09 m. More than 95% of patients were satisfied with their visual acuity, and less than 10% reported photic phenomena. The IOL showed an excellent rotational stability. CONCLUSIONS: The enhanced depth of focus IOL with 1.5 D of near add showed excellent intermediate and far visual performance and acceptable near visual restoration. Patient satisfaction was very high, and few patients reported disturbing photic phenomena.