Comparative Outcomes in Refractive Lens Exchange: Bilateral EDOF IOL vs. Mix and Match Approach in Emmetropic Presbyopic Patients.

Abstract

Purpose : To describe the refractive and visual outcomes at different distances (far and near) in different modalities in the approach of presbyopia in emmetropic patients.

Methods : We evaluated presbyopic patients with axial length (AL) between 22 and 24 mm who had undergone bilateral clear lens exchange. There were two surgical approaches: extended depth of focus (EDOF) only (n=16 eyes) and mix and match (MaM) approach (EDOF IOL in the dominant eye and trifocal IOL in the fellow eye), (n=12 eyes). At the 3-month postoperative visit, visual outcomes with undercorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), undercorrected near visual acuity (UNVA), corrected near visual acuity (CNVA) and refractive outcomes (residual spherical equivalent (SE)) were assessed.

Results : Mean age in all patients was 58.14 years and average AL was 23.39 mm. We had 8 male patients (2 in the MaM group and 6 in the EDOF only group) and 6 women (4 in the MaM group and 2 in the EDOF only group).

For the MaM group mean age was 54.4±4.27 years and mean AL was 23.12±6.45mm. CDVA and UDVA was 20/20 postoperatively. UNVA was Jaeger (J) 1 at 33 cm. Residual mean SE was -0.12±0.50 D. For the EDOF IOL mean residual SE was -0.08 D and for the trifocal IOL -0.16 D.

For the EDOF only group mean age was 61±8.05 years and mean AL was 23.58±0.47 mm. UDVA and CDVA was 20/20 postoperatively and UNVA was 20/20 at 33 cm. Residual mean SE was -0.50±0.58 D.

Conclusions : Visual outcomes were similar in both groups, both of which had high levels of visual satisfaction reported by the patient. We observed similar results in visual acuity both at far and near in both groups.

One of our limitations is that we have a small number of patients.

We are currently working in a larger patient data base along with taking into account more variables.

It is important to study more variables in order to determine which ones are relevant when deciding which approach we are taking in our patients giving them a more personalized surgical plan.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.