Real-life visual acuity outcomes following extended depth of focus intraocular lens implantation post-phacoemulsification targeting very mild myopia

PURPOSE: To investigate the visual acuity outcomes of Extended Depth of Focus (EDOF) intraocular lens (IOL) implantation targeting a postoperative refraction range of -0.10 to -0.50 diopters. METHODS: This retrospective single-center study was conducted in the Ophthalmology Department of Geneva University Hospitals, Geneva, Switzerland. It included patients who underwent cataract surgery with implantation of an EDOF IOL (Tecnis Symfony, Johnson & Johnson, USA), excluding those with ocular morbidities. IOL power was calculated using the SRK/T formula, targeting a post-operative refraction between -0.10 and -0.50 diopters. Visual acuity measurements were conducted for distance, intermediate and near vision, and the use of glasses was evaluated through the Patient-Reported Spectacle Independence Questionnaire (PRSIQ). RESULTS: Forty-eight eyes of 33 patients with EDOF IOL implantation during cataract surgery were enrolled. Fifteen patients underwent bilateral EDOF implantation, 12 underwent unilateral surgery, and 6 underwent mixed IOL implantation. The median patient age was 60 years, with a slight female majority. Postoperative uncorrected visual acuity for distance, intermediate and near vision was 0.03 logMAR, 0.07 logMAR and 0.18 logMAR, respectively. Spectacle independence in patients with bilateral EDOF IOL implantation was 100% for distance, 93% for intermediate, and 73% for near vision. Patients with unilateral EDOF IOL implantation and a phakic fellow eye showed slightly lower rates of spectacle independence. CONCLUSION: Targeting very mild myopia with the Symfony EDOF IOL in unilateral or bilateral cataract cases enhances near vision with minimal impact on intermediate vision, while maintaining unaffected distance vision, offering a safe and effective approach for a broader range of vision.