Extended Depth of Field Intraocular Lens for Cataract After Vitrectomy for Retinal Detachment: A Prospective Trial

INTRODUCTION: This study aimed to evaluate visual outcomes and patient satisfaction following implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens (IOL) in eyes with cataract developing after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). METHODS: Patients who underwent PPV for RRD, with or without macular involvement, and subsequently developed cataract were prospectively enrolled. Cataract surgery was performed with implantation of the Vivity EDOF-IOL (Alcon). Bilateral implantation was performed according to patient preference. Inclusion criteria were attached retina 3-6 months after PPV and corrected distant visual acuity of 0.3-0.7 logMAR. Primary outcomes were monocular and binocular, corrected and uncorrected distance, intermediate, and near visual acuity (CDVA, UDVA, DCIVA, UIVA, DCNVA, UNVA) at 6 months. Secondary outcomes included defocus curve and patient-reported satisfaction. RESULTS: Twenty-seven patients (43 eyes) underwent surgery at 6 ± 3 months after PPV (16 patients bilateral). Thirteen patients had RRD with macular involvement. In the RRD-affected eyes CDVA improved statistically significantly from 0.35 ± 0.16 to 0.03 ± 0.12 and UDVA from 1.01 ± 0.34 to 0.16 ± 0.19 logMAR at 6 months. Mean visual acuities at 6 months for RRD-affected eyes were DCIVA 0.53 ± 0.21, UIVA 0.44 ± 0.15, DCNVA 0.59 ± 0.23, and UNVA 0.47 ± 0.23 logMAR. Binocular UDVA, UIVA, and UNVA for the bilateral cases were - 0.04 ± 0.11, 0.29 ± 0.10, and 0.26 ± 0.13 logMAR, respectively. The defocus curve was comparable between macula-on, macula-off, and fellow eyes. Patient satisfaction was favorable with just two patients reporting halos. CONCLUSION: Using the Vivity EDOF-IOL in selected patients with cataract after successful PPV for RRD appears to be a safe and effective option, yielding favorable visual outcomes regardless of macular involvement. TRIAL REGISTRATION NUMBER: DRKS00037029.