Long-Term Clinical Outcomes of a Hydrofilic Extended Depth-of-Focus Intraocular Lens

To evaluate the long-term refractive and visual outcomes after sequential bilateral implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL). Forty eyes of 20 patients (mean age 66 years, range 54–74 years) underwent sequential bilateral cataract surgery with implantation of the Synthesis Plus EDOF IOL (Cutting Edge, France). This hydrophilic IOL incorporates a blue-light filter and a 2-mm EDOF center created using fourth- and sixth-order spherical aberrations with opposite polarity. Patients were examined 1 week, 1 month, 3 months, 6 months, and 3 years postoperatively. Evaluated parameters included subjective refraction, uncorrected and corrected distance visual acuity (UDVA, CDVA), intermediate visual acuity at 66 cm and 80 cm (UIVA, DCIVA), defocus curve, contrast sensitivity under photopic and mesopic conditions, and slit-lamp findings. Mean spherical equivalent was − 0.15 ± 0.27 D at 6 months and − 0.05 ± 0.19 D at 3 years. Mean UDVA was 0.02 ± 0.12 logMAR at 6 months and 0.03 ± 0.08 logMAR at 3 years. Mean CDVA was − 0.02 ± 0.07 logMAR and 0.02 ± 0.07 logMAR at the respective follow-ups. CDVA of 0.2 logMAR or better was achieved in 100% and 95% of eyes at 6 months and 3 years, respectively. At 3 years, the defocus curve maintained visual acuity of 0.2 logMAR or better from + 0.5 D to -1.5 D. Contrast sensitivity remained near the lower limit of normal values. The evaluated EDOF IOL provided stable long-term refractive results and very good distance and intermediate visual acuity over a 3-year follow-up period.