What is Extended Depth of Focus (EDoF) IOL

Intraocular lenses (IOLs) are used in refractive lens exchange and cataract surgery to replace natural human lenses and/or correct refractive errors. Over recent years, a broad spectrum of multifocal (MF) IOLs has been developed; MF IOLs have outweighed traditional monofocal IOLs. With the increase in life expectancy and lifestyle change, more patients are demanding spectacle-independent near and intermediate vision for their daily activities, aside from excellent distance vision. Moreover, those presbyopic patients who are not candidates for laser refractive surgery and do not want to rely on reading glasses can go for these presbyopia-correcting IOLs.

What are EDoF lenses?

The EDOF IOL (Extended Depth of Focus IOL) is a new technology in treating presbyopia-correcting lenses. The basic optical principle is to produce a single-extended focal point to enhance the depth of focus, unlike monofocal IOLs (which provide focus at only one distance) or MF IOLs (having 2 or 3 focal points).

Thus, there are fewer photic phenomena, glare, and halos as compared to those reported in MF IOLs. A potential disadvantage is a decrease in retinal image quality if aberrations are excessively increased.

Types of EDoF lenses and clinical application

We believe that two groups, pure EDOF IOLs, and hybrid MF-EDOF IOLs, should be differentiated based on the IOL technologies. Pure EDOF IOLs could be categorized based on spherical aberration optics or the pinhole effect; while hybrid MF-EDOF IOLs could be categorized as refractive-EDOF IOL, diffractive-EDOF IOL, and diffractive-refractive-EDOF IOL.

Pure EDOF IOLs

Spherical Aberration-Based EDOF IOLs

●SIFI Mini Well Ready

●WIOL CF

●TECNIS Eyhance ICB00

EDOF IOLs Utilizing the Pinhole Effect

●AcuFocus IC-8

●Morcher XtraFocus Pinhole Implant

Hybrid MF-EDOF IOLs

Hybrid MF Diffractive EDoF IOL

●Tecnis Symfony ZXR00

Hybrid MF Refractive EDoF IOL

●Lentis Mplus

●Lentis Mplus X

●Acunex Vario AN6V-SAV-IOL Lucid's

Hybrid MF Refractive-Difractive IOL

●SAV-IOL Info

●SAV-IOL Eden

●SAV-IOL Harmonis

●Technis Synergy ZFR00

Clinical performance of EDoF lenses

The EDoF lens's principle is that it produces a single focal point with an extended depth that offers clear distance to near vision. The design features a smoother transition between the individual focal lengths, which is achieved by introducing a small degree of optical aberration. EDoF IOLs provide sharp vision over a wide range of distances from intermediate (arm's length) to far, enabling you to perform most daily activities without glasses, such as sports, shopping, cooking, cleaning, watching TV, working on the computer, or driving. It offers patients an excellent balance between a wide visual accommodation range and a high-quality vision.

Is EDoF for everyone?

Not everyone is suited to an EDOF lens; a person's suitability to EDOF lenses is based on the health status of the eye and the critical pre-operative measurements. Eyes with unusual surface curvature or eyes with significant other problems such as age-related macular degeneration or glaucoma might not be suitable.

If someone has ocular comorbidity in either eye (e.g., severe dry eye disease, irregular astigmatism, epiretinal membranes, macular degeneration),

Conclusion

A broad range of IOLs available in the market; a careful and thorough patient examination and the IOL selection, based on his lifestyle and visual needs, would be recommended. Both types of EDOF IOLs are perfect solutions for those who want to remain spectacle-independent. The lens model can be selected based on the patient's profession, need, as well as their activity level, and preferences.