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

Su Hwan Park; Sung Il Kim; Jung Hyo Ahn; Jong Hoon Shin; Su Jin Kim; Ji Eun Lee

doi:10.3341/jkos.2019.60.9.835

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Park, Kim, Ahn, Shin, Kim, and Lee: Clinical Outcomes of Patients Implanted with Bifocal and Extended Depth of Focus Intraocular Lenses

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(9): 835-842.

Published online: 18 September 2019

DOI: https://doi.org/10.3341/jkos.2019.60.9.835

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

Su Hwan Park, MD^1,², Sung Il Kim, MD^1,², Jung Hyo Ahn, MD^1,², Jong Hoon Shin, MD^1,², Su Jin Kim, MD, PhD^1,², Ji Eun Lee, MD, PhD^1,²

¹Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

²Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Address reprint requests to Ji Eun Lee, MD, PhD. Department of Ophthalmology, Pusan National University Yangsan Hospital, #20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: 82-55-360-2131, Fax: 82-55-360-2161, jiel@hanmail.net

Received 18 April 2019 Revised 11 May 2019 Accepted 16 August 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Bifocal, Extended depth of focus, Multifocal intraocular lens, Visual acuity

Figures and Tables

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.

Table 1

Demographics of the study groups

Values are presented as mean ± standard deviation or number. 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.

logMAR = logarithm of minimal angle of resolution; D = diopter; IOP = intraocular pressure.

^*Student t-test.

Table 2

Postoperative binocular uncorrected visual acuity

Values are presented as mean ± standard deviation. 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. LogMAR = logarithm of minimal angle of resolution; D = distant visual acuity; I = intermediate visual acuity; N = near visual acuity.

^*Student t-test.

Table 3

Postoperative refractive errors in the study groups

D = diopter.

^*Student t-test.

Table 4

Comparison of postoperative refractive errors in bifocal and EDOF implanted eyes in group C

Values are presented as mean ± standard deviation or number. Group C is bifocal and EDOF intraocular lens implantation in each eye.

EDOF = extended depth of focus; D = diopters.

^*Student t-test.

Notes

This study was supported by a 2019 research grant from Pusan National University Yangsan Hospital.

We thank Ji Won Jung, Jung Ae Bae and Young Hee Kim in BalGeunNun Eye Hospital for valuable advice.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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