Prospective Evaluation Of Visual Performance Of A Novel Partial Depth Of Field Intraocular Lens Using A Monovision Strategy

Purpose: To assess visual and patient-reported outcomes of a partial-depth of field (DOFi) intraocular lens (IOL) using a monovision strategy. Setting: Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria. Design: Single-center, prospective, clinical trial. Methods: Forty-nine patients underwent bilateral cataract surgery, implantation of the partial-DOFi Vivinex Impress TM XY1-EM IOL (Hoya Surgical Optics), and returned for final follow-up. Follow-up occurred between 30 and 90 days post-operatively, at which manifest refractive spherical equivalent (MRSE), binocular uncorrected visual acuities, defocus curve, corneal wavefront aberrometry, pupil size, IOL tilt and decentration, near stereopsis, photic phenomena and the Visual Functioning-7 questionnaire were evaluated. Results: Postoperative MRSE was -0.14±0.26D and -0.84±0.44D in dominant and non-dominant eyes, respectively. Binocular UDVA and UIVA (at both 80cm and 66cm) reached 0.05 logMAR or better, with a mean UNVA of 0.20±0.11 logMAR. The defocus curve confirmed a broad visual function (≤0.2 logMAR) across a range from +0.50D to −2.22D. Intermediate vision was significantly influenced by photopic pupil diameter and corneal spherical aberration (p<.05). Low levels of IOL tilt, decentration, and corneal HOAs were observed. Patients reported high visual function (VF-7) and normal stereopsis, without disturbing photic phenomena. Conclusion: Utilizing a novel partial-DOFi IOL in a monovision protocol yielded excellent distance to intermediate vision as well as functional near visual acuity. These results, supported by high subjective visual function and the lack of bothersome photic phenomena, suggest the potential of this strategy for extending the range of vision.