The Tolerance of Refractive Errors of Extended Depth of Focus Intraocular Lens in Patients with Previous Corneal Refractive Surgery

Purpose: To evaluate the tolerance of refractive errors and visual outcomes of extended depth of focus intraocular lens (EDOF IOLs) in patients with previous corneal refractive surgery for myopia. Methods Patients from Wuhan Aier Eye Hospital with previous myopia excimer laser correction underwent cataract surgery and implantation of an EDOF IOL. The follow-up period was three months. The uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, UNVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), defocus curve, optical quality, including modulation transfer functions (MTF) and Strehl ratio (SR), National Eye Institute Visual Functioning Questionnaire-14 for Chinese people (VF-14-CN), spectacle independence, and dysphotopsia were assessed. Results At the final visit, UDVA, CDVA, UIVA, and UNVA (logMAR) were 0.07 ± 0.09, 0.01 ± 0.04, 0.10 ± 0.08, 0.20 ± 0.11, respectively. The mean spherical equivalent (SE) was ± 0.75 ± 0.49D, where 42% (21 eyes) were within ± 0.50D, 70% (35 eyes) were within ± 1.00D, and 98% (49 eyes) were within ± 1.50D. The defocus curve showed that visual acuity could reach 0.1 in the refractive range of 0 ~ -1.5D. SR and MTF values of 10, 15, 20, 35, and 30 c/d spatial frequency were measured with a 3 mm pupil diameter after removing the influence of low-order aberrations, which were all higher than the values before the operation. The mean VF-14-CN questionnaire score was 51.02 ± 2.95 out of 56. Conclusion The EDOF IOLs have a certain tolerance for refractive errors, and they are recommended for patients with prior myopia excimer laser surgery to achieve satisfactory visual performance.