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Subjective and objective depth of field measures in pseudophakic eyes: comparison between extended depth of focus, trifocal and bifocal intraocular lenses

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Abstract

Purpose

To evaluate different intraocular lens (IOL) designs and to determine whether extended depth of focus (EDOF) lenses provide a higher depth of field (DOF) than the rest considering both subjective and objective measurements.

Methods

A total of 100 eyes undergoing cataract surgery were divided into six groups depending on the IOL implanted: bifocal designs were Tecnis ZMB and ZLB (Abbott Laboratories, Illinois, USA), trifocal designs were Finevision (PhysIOL, Liège, Belgium) and AT LISA Tri (Carl Zeiss Meditec., Jena, Germany) and EDOF designs were Symfony (Abbott Laboratories, Illinois, USA) and MiniWell (SIFI MedTech, Catania, Italy). Subjective DOF was obtained from defocus curves for the range of vergences which provide a VA over 0.1 LogMAR and 0.2 LogMAR. Aberrometry was measured and Visual Strehl Optical Transference Function (90%) was used to quantify objectively the DOF.

Results

Symfony IOL group showed better subjective and objective DOF compared to the rest of IOL groups, with statistically significant differences (p < 0.001). Comparison between subjective and objective DOF showed that subjective measures were higher for all IOLs, being these differences statistically significant for all groups when compared with objective measures (p < 0.001).

Conclusion

Objective and subjective measures of DOF are not comparable due to differences in methodologies and criterions to define the level of degradation acceptance. Nevertheless, both objective and subjective measures demonstrate a greater DOF for EDOF designs compared to bifocal and trifocal IOLs, being the Symfony IOL the one providing higher levels of subjective and objective DOF.

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Funding

The author David P Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471. The rest of the authors have not received funding for performing this research.

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Authors and Affiliations

  1. Department of Ophthalmology, University Hospital Quirónsalud, Madrid, Spain

    Carlos Palomino-Bautista, Rubén Sánchez-Jean & David Carmona-González

  2. Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain

    David P. Piñero & Ainhoa Molina-Martín

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  1. Carlos Palomino-Bautista
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Correspondence to Ainhoa Molina-Martín.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (CEIm-FJD) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Palomino-Bautista, C., Sánchez-Jean, R., Carmona-González, D. et al. Subjective and objective depth of field measures in pseudophakic eyes: comparison between extended depth of focus, trifocal and bifocal intraocular lenses. Int Ophthalmol 40, 351–359 (2020). https://doi.org/10.1007/s10792-019-01186-6

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