Purpose:

Multifocal intraocular lenses (MIOL) and lenses with extended range of focus (EDOF) typically have a wider range of good visual acuity compared to monofocal IOL. The aim of this retrospective analysis is to investigate how visual acuity is affected by residual refractive errors in case of MIOL & EDOF lenses.

Methods:

We retrospectively compared consecutive cases of cataract surgery or refractive lens exchange for the following MIOL or EDOF lenses (n=eyes): - Comfort MF15 (EDOF, Oculentis, n=1100) - Mplus MF20 (EDOF, Oculentis, n=90) - MiniWell (EDOF, Sifi Medtec, n=60) - WIOL (EDOF, Medicem, n=40) - Symfony (EDOF, J&J, n=60) - AT LARA (EDOF, CZM, n=55) - AT LISA tri (trifocal, CZM, n=600) Postoperative assessment was performed between 3 month and 5 years after surgery. It included monocular UDVA, CDVA, residual refraction and astigmatism as well as defocus curves. We plotted postoperative efficacy (UDVA-CDVA) vs. residual spherical equivalent, residual astigmatism and residual total refractive error.

Results:

With respect to the plot x=residual total refractive error vs. y=UDVA(post)-CDVA(post), the quadratic fit curve in case of the EDOF IOL Comfort MF15 was y=0.04*x^2+0.15*x with R^2=0.51. In case of the trifocal LISA tri the equation read y=0.00*x^2+0.20*x with R^2=0.52. This implies that for small deviations from emmetropia 1.5 (2) Snellen lines per 1D of residual total refractive error are lost in case of the Comfort MF15 EDOF IOL (trifocal LISA tri). The other EDOF and trifocal IOLs displayed a similar behavior.

Conclusions:

EDOF IOLs appear to be slightly more forgiving with respect to residual refractive errors compared to trifocal lenses.