Long-term results after bilateral implantation of extended depth of focus intraocular lenses with mini-monovision.

PURPOSE: To assess long-term clinical results following bilateral Tecnis Symfony (ZXR00: Johnson & Johnson Vision, Santa Ana, CA, USA) intraocular lens (IOL) implantation with mini-monovision.

METHODS: The medical records of cataract patients who underwent bilateral implantation of ZXR00 with intended mini-monovision (target refraction of -0.3 D in dominant eye and -0.6 D in non-dominant eye) between April 2019 and March 2021 were assessed. Postoperative uncorrected and corrected distance visual acuity (UDVA, CDVA), uncorrected intermediate VA (UIVA), uncorrected near VA (UNVA), and rate of spectacle dependence for near-distance were investigated at 3 months and 2 years after surgery.

RESULTS: This study included sixty-one patients (122 eyes) with average age of 61.8 ± 7.7 years. At 2 years postoperatively, binocular logMAR UDVA, UIVA, UNVA, and CDVA were 0.086 ± 0.094, 0.056 ± 0.041, 0.140 ± 0.045, and 0.012 ± 0.024, respectively. The monocular manifest refraction spherical equivalent (MRSE) was -0.31 ± 0.38 in dominant eye and -0.53 ± 0.47 in non-dominant eye at 3 months postoperatively, and -0.38 ± 0.43 in dominant eye and -0.61 ± 0.54 in non-dominant eye at 2 years postoperatively. Eight out of 61 (13.1%) patients required near glasses after three months of surgery, and they remained at nine out of 61 (14.8%) patients after two years.

CONCLUSIONS: The bilateral implantation of ZXR00s with mini-monovision allows for a good VA at wide range of distance from far to near, thereby resulting in high rate of spectacle independence. These results have held up well even after two years after surgery.