Postoperative Visual Function of Extended Depth-of-Focus Intraocular Lenses Versus Monofocal Lenses

PURPOSE: To assess the effects of intraocular lens (IOL) de- centration and tilt, as well as age, on postoperative visual function (corrected distance visual acuity [CDVA] and contrast sensitivity) by comparing an extended depth-of-focus IOL using higher order aspheric optics against a monofocal IOL from the same platform. METHODS: This retrospective observational study targeted patients without other eye diseases who underwent surgery to implant the Tecnis Eyhance OptiBlue or the monofocal IOL Tecnis OptiBlue 1-Piece (J&J Vision) during cataract surgery from November 2021 to December 2022. The effects of age, axial length, IOL decentration, tilt, and corneal higher order aberrations (HOAs) on the postoperative 5 m CDVA and area under log contrast sensitivity function (AULCSF) under phot- opic and scotopic conditions were evaluated within 3 months of surgery. RESULTS: No significant difference was found in postopera- tive CDVA between the Tecnis Eyhance OptiBlue group (n = 61 eyes) and the Tecnis OptiBlue 1-Piece group (n = 35 eyes), but AULCSF was significantly better in the Tecnis Eyhance OptiBlue group for photopic (1.58 +/- 0.13 vs 1.46 +/- 0.18; P = .002) and scotopic (1.71 +/- 0.11 vs 1.59 +/- 0.19; P = .002) eyes. Multivariate analysis showed a negative correlation between AULCSF and IOL decentration and age in the Tecnis Eyhance OptiBlue group ( P < .01), with no significant correlation with tilt, axial length, and corneal HOAs. CONCLUSIONS: The Tecnis Eyhance OptiBlue yielded signifi- cantly better contrast sensitivity under photopic and scotopic conditions than the Tecnis OptiBlue 1-Piece. However, it is important to consider the effects of IOL decentration and age when evaluating the contrast sensitivity of the Tecnis Eyhance OptiBlue.