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Purpose: To evaluate clinical tolerance to induced astigmatism in pseudophakic eyes bilaterally implanted with an extended depth of focus (EDOF) intraocular lens (AT LARA ® , Carl Zeiss Meditec). We hypothesized that small amounts of induced astigmatism may be clinically well tolerated by patients implanted with this EDOF IOL. Methods: Prospective study including 10 patients (20 eyes) bilaterally implanted with the same EDOF IOL. Monocular defocus curves were obtained under photopic conditions after introducing cylindrical lenses of +1.00 D, +2.00 D, and +3.00 D at with-the-rule (WTR) and against-the-rule (ATR) orientations. Results: The IOL demonstrated good tolerance up to +1.00 D of induced astigmatism, with significant reductions in visual acuity at higher magnitudes of astigmatism. Tolerance was higher for ATR astigmatism compared to WTR, consistent with axis-dependent depth-of-focus effects. Conclusion: The AT LARA ® EDOF IOL maintained functional visual performance with up to +1.00 D of regular astigmatism, while higher magnitudes led to clinically meaningful degradation. Axis orientation modulated performance, with ATR preserving intermediate and near vision and WTR favoring distance. Keywords: extended depth of focus intraocular lens, pseudophakia, astigmatism tolerance, defocus curve, with-the-rule, against-the-rule, toric intraocular lens
Hida et al. (Mon,) studied this question.