A Blended Approach to Spectacle Independence After Cataract Surgery Using a Novel Extended Depth of Focus Intraocular Lens

To evaluate the effectiveness of a blended approach to spectacle independence after cataract surgery using a novel extended depth of focus (EDOF) lens. This retrospective comparative study took place at Mosman Eye Centre, Australia. This was a single-site, single-surgeon study evaluating patients who underwent consecutive bilateral cataract surgery with implantation of a novel EDOF lens using a symmetrical (both eyes +1.50 diopter D add) or blended (dominant eye +1.50 D, non-dominant +3.00 D) approach. Endpoints included uncorrected (UDVA) and corrected (CDVA) distance visual acuity and intermediate (45 and 60 cm) and near (30 cm) visual acuity at 1 month. Additional endpoints included postoperative refraction, spectacle independence, overall satisfaction with vision, and adverse events. Overall, 148 eyes of 74 patients were included, 41 patients in the symmetrical group and 33 in the blended group. The mean age was 72.28 ± 8.18 years (range: 50 to 89 years) with 33.78% being men. Both near and distance visual acuity improved significantly for both refractive approaches (P < .001). All eyes (148/148) were within 0.18 D of emmetropia postoperatively. Comparing the two approaches, postoperative distance, intermediate, and near UDVA was significantly better for the blended approach: -0.09 ± 0.05 versus -0.03 ± 0.07 at 6 m (P = .03), 7.97 ± 2.98 N versus 9.12 ± 2.63N at 30 cm (P = .014), .47 ± 2.21 N versus 8.68 ± 2.17 N at 45 cm (P = .001) and 8.32 ± 2.48 N versus 9.12 ± 2.00 N at 60 cm (P = .03). Postoperative adverse events were comparable between the groups and similar to previous reports. Blended EDOF IOL implantation using +1.50 and +3.00 D addition resulted in excellent distance, intermediate, and near vision, with a high rate of spectacle independence and low rate of reported visual disturbances. Future randomized comparative trials with a larger sample size, longer follow-up, and additional objective assessments of postoperative visual quality, such as contrast sensitivity, are needed to further validate these findings.