Comparison of Anterior Chamber Depth Changes of Two Hydrophobic Acrylic Intraocular Lenses in the Capsular Bag: A Prospective, Randomized, Contralateral Eye, Multicenter Study

Purpose: To evaluate postoperative changes in anterior chamber depth (ACD), intraocular lens (IOL) tilt, and decentration of the Clareon IOL in a capsular bag compared with those of the AcrySof IQ IOL. Patients and Methods: In this prospective multicenter study, we randomly assigned patients scheduled for bilateral cataract surgery to receive the Clareon IOL in one eye and the AcrySof IQ IOL (both manufactured by Alcon Vision LLC, Fort Worth, TX, USA) in the fellow eye. ACD, IOL tilt, decentration, visual acuity, and subjective refraction were measured 1 day, 1 week, and 1, 3, and 6 months after surgery. The primary objective was to demonstrate the equivalence between Clareon and AcrySof IQ IOL regarding ACD changes from 1 day to 6 months. Results: Overall, 64 eyes from 32 patients were included. The Clareon IOL met the equivalence criteria; the 95% confidence interval for the difference in ACD change (0.026 mm; 95% confidence interval, − 0.02 to 0.072) was within − 0.15 and 0.15 mm. At 6 months, the means ± standard deviations of the ACD, IOL tilt, and decentration were 4.26 ± 0.30 mm, 4.3 ± 1.9°, and 0.17 ± 0.11 mm for Clareon IOL, and 4.23 ± 0.30 mm, 4.0 ± 1.9°, and 0.16 ± 0.11 mm for AcrySof IQ IOL, respectively (P = 0.052, 0.421, and 0.916, respectively). The subjective spherical equivalence at 6 months was − 0.01 ± 1.03 and − 0.08 ± 0.90 D for Clareon IOL and AcrySof IQ IOL, respectively. Conclusion: The Clareon IOL was equivalent to the AcrySof IQ IOL regarding ACD changes from 1 day to 6 months. No significant differences were observed in ACD, IOL tilt, or refractive outcomes at 6 months between the two IOLs in the same patients. Both IOLs showed good stability in the bag through 6 months. Keywords: monofocal intraocular lens, anterior chamber depth, tilt, decentration, refraction