Comparison of Outcomes of Non-diffractive Extended Depth of Focus Intraocular Lens and Diffractive Extended Depth of Focus Intraocular Lens

Background Extended depth of focus (EDOF) intraocular lenses (IOLs) are designed to provide spectacle-free vision across distances. EDOF IOLs can be categorized as diffractive, e.g., Symfony (Abbott Medical Optics, Santa Ana, CA), or non-diffractive, e.g., Vivity (Alcon Inc., Geneva, Switzerland). Non-diffractive and diffractive EDOF technologies offer different approaches to extending the range of focus, with varying effects on visual quality, including glare, halos, and contrast sensitivity. Aim To compare visual outcomes between non-diffractive and diffractive EDOF intraocular lenses. Methodology This prospective, interventional, randomized, double-arm, comparative study was conducted at a tertiary eye care center in North India, from May 2022 to December 2022. Eighty eyes of 40 patients were enrolled and divided into two groups (Symfony vs. Vivity EDOF lenses). Patients aged 40-80 years with bilateral age-related cataract were included. Standardized phacoemulsification was performed by an experienced surgeon. Visual acuity (distance, intermediate, near) and contrast sensitivity were measured objectively. Glare sensitivity, halos, and patient satisfaction were assessed separately using subjective responses in terms of yes/no. All evaluations were carried out during the one-month postoperative follow-up. Results The Mann-Whitney U test was used to compare the Symfony and Vivity groups, each consisting of 40 patients. Before surgery, both the Vivity and Symfony EDOF IOL groups had similar uncorrected vision for distance and near. After surgery, patients in both groups showed clear improvement in uncorrected vision at all distances, i.e., near, intermediate, and far. When comparing the two groups on day one, day seven, and day 30 after surgery, there were no significant differences in visual acuity outcomes, as all p-values for distance, intermediate, and near vision were greater than 0.05. Contrast sensitivity was nearly the same in both groups on days one, seven, and 30 after surgery. There was no significant difference between the two groups at any time. Both groups had high satisfaction rates, with 38 (95%) patients in each group saying they were satisfied with their surgery. Only two (5%) patients in each group were not satisfied. Vivity EDOF lenses gave better results in terms of glare than Symfony EDOF lenses on all postoperative days (days one, seven, and 30), with statistically significant results. Conclusions Our study found no significant differences between Symfony and Vivity IOLs in visual outcomes, contrast sensitivity, or spectacle independence; however, Vivity demonstrated slightly better glare acuity.