Comparison of Dynamic Visual Acuity After Diffractive Extended Depth of Focus and Monofocal Intraocular Lens Implantation for Patients With Age-Related Cataract

Purpose: To compare the dynamic visual acuity (DVA) after implantation of diffractive extended depth of focus (EDOF) TECNIS Symfony ZXR00 (Johnson & Johnson Vision, Inc) or monofocal intraocular lens (IOL) in patients with age-related cataract. Methods: A total of 109 patients with 218 eyes diagnosed as having age-related cataract were assessed for eligibility, and 80 patients with 160 eyes (40 patients each in EDOF and monofocal groups) were included in this study. Phacoemulsification and IOL implantation were performed according to grouping. The monocular and binocular uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) static visual acuity, and corrected DVA of 20 and 80 degrees per second (dps) were examined 1 month postoperatively. Results: The postoperative monocular ( P = .003) and binocular ( P = .004) UNVA were significantly better in the EDOF group than the monofocal group. The binocular 80 dps DVA was significantly better in EDOF group ( P = .042), whereas no statistical differences were observed in monocular 20 dps DVA, monocular 80 dps DVA, or binocular 20 dps DVA between two groups (all P > .05). The multivariate linear regression analysis suggested that postoperative binocular mean sphere ( P = .026), binocular mean axial length ( P = .047), and age ( P = .028) were significantly associated with binocular 80 dps DVA. Conclusions: The study revealed that the diffractive EDOF IOL provided better distance DVA than the monofocal IOL for patients with age-related cataract when observing high-speed moving targets binocularly. The research provided the basis of dynamic vision-guided IOL selection for patients with cataract.