J Korean Ophthalmol Soc.  2019 Sep;60(9):835-842. 10.3341/jkos.2019.60.9.835.

Clinical Outcomes of Patients Implanted with Bifocal and Extended Depth of Focus Intraocular Lenses

• Park SH
• Kim SI
• Ahn JH
• Shin JH
• Kim SJ
• Lee JE

• KMID: 2459127
• DOI: http://doi.org/10.3341/jkos.2019.60.9.835

Abstract

PURPOSE
To compare the postoperative clinical outcomes after cataract surgery with implantation of bifocal intraocular lenses (IOLs) and extended depth of focus (EDOF) IOLs.
METHODS
A total of 60 patients were divided into three groups, and each group included 20 patients of 40 eyes: group A with a +3.25 D bifocal IOL in both eyes, group B with an EDOF IOL in both eyes, and group C with a +3.25 D bifocal in one eye and an EDOF IOL in the other eye. We retrospectively reviewed the patients' medical charts to analyze their binocular uncorrected visual acuities (UCVAs; distant, intermediate, and near) and refraction at postoperative 3 months.
RESULTS
The binocular distant UCVAs were 0.04 ± 0.01, 0.05 ± 0.02, and 0.04 ± 0.01 in groups A, B, and C, respectively, and there were no differences between the groups (p > 0.05). The intermediate UCVAs were 0.16 ± 0.01, 0.10 ± 0.01, and 0.10 ± 0.01, respectively, and group A was the lowest (A-B, p = 0.031; A-C, p = 0.018; B-C, p = 1.000). The near UCVAs were 0.05 ± 0.01, 0.24 ± 0.01, and 0.13 ± 0.01, respectively, and there were significant differences between the groups (A-B, p < 0.001, A-C: p = 0.009; B-C, p = 0.003).
CONCLUSIONS
There were no significant differences among the three groups in binocular distant UCVA, and groups B and C showed better intermediate UCVAs than group A. Near UCVA was ranked in the order of groups A, C, B.

Keyword

Bifocal; Extended depth of focus; Multifocal intraocular lens; Visual acuity

MeSH Terms

Cataract
Humans
Lenses, Intraocular*
Retrospective Studies
Telescopes
Visual Acuity

Figure

• 

  Figure 1 Flow diagram of the study. Their medical records were retrospectively analyzed. 120 eyes were divided into three groups: Bifocal intraocular lens (IOL) implantation in both eyes, extended depth of focus (EDOF) IOL implantation in both eyes and Bifocal & EDOF IOL implantation in each eye. In these three groups, distant, intermediate, and near visual acuity, spherical equivalent, and astigmatism were examined at preoperative and postoperative time points.

• 

  Figure 2 Comparison of postoperative distant uncorrected visual acuity (logMAR). Distant uncorrected visual acuity was improved with significant difference, but there were no significant differences among groups at 3 months postoperatively. Group A means bifocal intraocular lens implantation in both eyes, Group B means extended depth of focus intraocular lens implantation in both eyes, Group C means bifocal and extended depth o f focus intraocu lar lens im plantation in each eye. LogMAR = logarithm of minimal angle of resolution.

• 

  Figure 3 Comparison of postoperative intermediate uncorrected visual acuity (logMAR). Group B and C showed significant improvement compared with group A. There was no significantly difference between group B and C. Group A means bifocal intraocular lens implantation in both eyes, Group B means extended depth of focus intraocular lens implantation in both eyes, Group C means bifocal and extended depth of focus intraocular lens implantation in each eye. LogMAR = logarithm of minimal angle of resolution.

• 

  Figure 4 Comparison of postoperative near uncorrected visual acuity (logMAR). Group A showed the highest improvement and group B showed the lowest improvement. There were significantly differences among groups. Group A means bifocal intraocular lens implantation in both eyes, Group B means extended depth of focus intraocular lens implantation in both eyes, Group C means bifocal and extended depth of focus intraocular lens implantation in each eye. LogMAR = logarithm of minimal angle of resolution.

• 

  Figure 5 Binocular visual acuity at various defocus levels. Group A is bifocal intraocular lens implantation in both eyes, Group B is extended depth of focus intraocular lens implantation in both eyes, Group C is bifocal and extended depth of focus intraocular lens implantation in each eye. D = diopter.

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