Maximizing extend visual outcomes with extend focus intraocular lens in eyes with axial length shorter than 24 mm

To evaluate the efficacy of the Tecnis^® Symfony^® ZXR00 lens in achieving optimal visual outcomes for cataract surgery patients with axial length (AL) shorter than 24 mm.

A total of 21 subjects (37 eyes) were submitted to cataract surgery and implantation of Tecnis^® Symfony^® ZXR00 lens (Johnson & Johnson Vision) was assessed. Patients were examined at 5 m, 80 cm, and 40 cm for uncorrected distance visual acuity (UCDVA) and corrected distance visual acuity (CDVA), uncorrected intermediate (UCIVA), and uncorrected near visual acuity (UCNVA). Further, based on the optimal distance correction, the monocular defocusing curve in the range of +0.5 to -3.5 D was investigated. A simple patient-reported spectacle independence questionnaire (PRSIQ) was used to evaluate subjects’ subjective feelings about their dependence on glasses at various distances. Multiple linear regression was employed to examine the association amony intraocular lenses (IOLs) diopter, AL, corneal curvature, anterior chamber depth, mean manifest refractive spherical equivalent, pupil, pupil/scan, target refraction, and near vision (logMAR).

The study demonstrated enhanced UCNVA alongside comparable distant vision and UCIVA outcomes in eyes with AL shorter than 24 mm. Mean post-operative UCDVA significantly improved from preoperative levels 0.530±0.406 (P=0.000). Notably, 83.3% of eyes achieved 0.01 logMAR in UCNVA. Five unilateral cases with blended IOL implantation also showed satisfactory visual acuity and satisfaction. The 90.5% (19/21) achieved spectacle independence. The average score for self-reported spectacle-independence on the PRSIQ was 3.52 with a standard deviation of 0.98. The results of the regression analysis revealed that one predictor, the pupil/scan accounted for 27.6% of the variation in near vision [logMAR; F(1,35)=13.33, P<0.01].

The results affirm the effectiveness of the Tecnis^® Symfony^® ZXR00 lens in enhancing visual outcomes for cataract surgery patients with AL shorter than 24 mm. Additionally, the pupil/scan emerges as a critical factor influencing postoperative near vision.