EDOF intraocular lens in eyes with preexisting retinal disease
Reviewed by Sofia Rokerya

Extended depth of focus (EDOF) intraocular lens (IOL) offers improved near and intermediate vision, aiming to reduce spectacle dependence in cataract patients. This study aims to evaluate the performance of EDOF lenses following cataract surgery in patients with retinal pathology. This was a case control retrospective study whereby data was collected from records of 33 eyes with retinal pathology (24 eyes with epiretinal membrane (ERM) and nine eyes with dry age-related macular degeneration (AMD)) and 100 control patients who underwent cataract surgery with implantation of the EDOF IOL by the same surgeon during the study period. Patients’ overall satisfaction, spectacle dependence, visual perception, and side-effects were evaluated with a self-reported questionnaire survey. Patients with at least three weeks of postoperative follow-up were included in the study. The study group (retinal pathologies) consisted of mild dry AMD or stable mild ERM. Mild AMD category 1 and 2 was included as defined based on the clinical features specified in the Age-RElated Disease Study (AREDS) Classification. ERM was graded according to the classification suggested by Hwang, et al. Only cases of ERM with inner retinal thickening and minimal retinal change without retinal distortion or intraretinal fluids were included. The results indicated that mean uncorrected visual acuities (logMAR) were significantly better in the healthy eyes compared with the eyes with retinal pathologies: 0.05 and 0.10, p=0.011 (distance), 0.06 and 0.16, p=0.001 (intermediate), and 0.20 and 0.28, p=0.026 (near), respectively. No or rare use of spectacles for any distance was reported by 71% and 38% of patients, respectively (p=0.004). Haloes / glare were reported by 17% and 23%, respectively (p=0.556); only in 7% and 4% was it clinically disturbing (p>0.999). The same IOL would be chosen again by 77% and 73% of patients, respectively (p=0.550). The study concluded that patients with retinal pathology who were implanted with an EDOF IOL demonstrated good distance uncorrected visual results with reasonable intermediate and near uncorrected visual results alongside high satisfaction; however, results were inferior to those of the control healthy eyes. The findings of this study are encouraging but also suggest that further comparative and prospective studies with longer follow-up and larger sample size are required. Limitations: Retrospective nature, short follow-up data, small sample size, binocular single vision and objective contrast sensitivity were not measured.

Performance of extended depth of focus intraocular lens in eyes with preexisting retinal disease.
Reitblata O, Vellemand DA, Levya A, et al.
OPHTHALMOLOGICA
2024;247:241–50.