Extended Depth of Focus Versus Monofocal IOLs in Patients With High Myopia: Objective and Subjective Visual Outcomes

PURPOSE: To compare the objective and subjective outcomes between the extended depth of focus (EDOF) Mini Well intraocular lens (IOL) and the aspheric monofocal Mini-4-Ready IOL (both SIFI S.p.A.) in patients with high myopia. METHODS: In this prospective comparative study, 40 patients with high myopia (axial length ≥ 26 mm) were enrolled: 20 patients were bilaterally implanted with the EDOF Mini Well IOL (EDOF group) and 20 patients were bilaterally implanted with the 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, objective optical quality (calculated with Optical Quality Analysis System; Visiometrics SL), halometry, and reading performance. Subjective visual quality was evaluated with National Eye Institute Refractive Error Quality of Life Instrument 42 scores. RESULTS: All visual acuities were significantly better in the EDOF group ( P ⩽ .04) except monocular and binocular uncorrected and corrected distance visual acuities for distance ( P ≥ .50). Defocus curves for myopic and hyperopic values were better in the EDOF group ( P ⩽ .05), apart from +0.50 to −0.50 D ( P ≥ .16). Contrast sensitivity curves was worse in the EDOF group in the mesopic-with-glare condition ( P ⩽ .04). No differences were found in halometric values ( P ≥ .15) and OQAS outcomes ( P ≥ .47). National Eye Institute Refractive Error Quality of Life Instrument 42 subscale scores were better for expectation, near vision, activity limitations, and dependence on correction in the EDOF group ( P ⩽ .04). CONCLUSIONS: Intermediate and near visual acuities were better in the EDOF group than in the monofocal group, with a comparable visual quality index between groups. [ J Refract Surg . 2022;38(3):158–166.]