Extended Depth of Focus Versus Monofocal IOLs: Objective and Subjective Visual Outcomes

PURPOSE: To evaluate and compare the objective and subjective outcomes between bilateral implantation of the extended depth of focus (EDOF) Mini Well intraocular lens (IOL) and the aspheric monofocal Mini-4-Ready IOL (both SIFI S.p.A., Catania, Italy). METHODS: This prospective comparative study included 25 patients (50 eyes) bilaterally implanted with an EDOF Mini Well IOL (EDOF group) and 25 patients (50 eyes) bilaterally implanted with a Mini-4-Ready IOL (monofocal group). Three-month follow-up data included corrected and uncorrected distance visual acuity at 4 m and 80, 67, and 40 cm. Defocus curves, subjective and objective contrast sensitivity, and objective optical quality (modulation transfer function cutoff and Strehl ratio calculated with Optical Quality Analysis System [OQAS]; Visiometrics SL, Terrassa, Spain), halometry, and reading performance were measured. Subjective visual quality was evaluated based on National Eye Institute Refractive Error Quality of Life Instrument 42 (NEI RQL-42) scores. RESULTS: Postoperative uncorrected and corrected monocular and binocular intermediate and near visual acuity was significantly better in the EDOF group ( P < .001). No differences were observed for distance visual acuity ( P ⩾ .312). Defocus curve outcomes for myopic values were better in the EDOF group ( P < .001). No significant differences were found in hyperopic (obtained in steps of +0.50 diopters [D] from emmetropia to 1.50 D) values ( P ⩾ .095), contrast sensitivity curves ( P ⩾ .087), or OQAS outcomes ( P ⩾ .138). Halometric values were significantly better in the monofocal group ( P < .05). There was a correlation between mean keratometry values and intermediate/near visual acuity. Significantly better NEI RQL-42 subscale scores for near vision, far vision, activity limitations, glare, dependence on correction, and suboptimal correction were noted in the EDOF group ( P < .05). CONCLUSIONS: Intermediate and near visual acuity was better after EDOF IOL than after aspheric monofocal IOL implantation while maintaining similar levels of visual quality, except for halo perception. [ J Refract Surg . 2020;36(4):214–222.]