Observational studyJournal of cataract and refractive surgery2026
Comparative analysis of tolerance to induced astigmatism across various categories of intraocular lenses.
Observational study in Journal of cataract and refractive surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare tolerance to induced astigmatism (TIA) across 4 intraocular lenses (IOLs).
settingMedical University of South Carolina, Charleston, South Carolina.
designProspective observational study.
methodsPatients underwent cataract surgery with a standard monofocal (ZCB00), enhanced monofocal (DIB00), diffractive violet light filter (VLF) extended depth of field (DOFi) (ZXR00V), or VLF full-DOFi (DRN00V) IOL. At 1 to 3 months postoperatively, astigmatic defocus (0.5 to 2.0 diopters [D]) was simulated in with-the-rule (WTR), oblique, and against-the-rule (ATR) orientations.
results100 patients were included. Distance-corrected intermediate visual acuity was statistically significantly better with VLF extended DOFi compared with the monofocal ( P ≤ .001) and enhanced monofocal IOLs ( P = .002). Distance-corrected near visual acuity was significantly better with VLF Full-DOFi IOL than with all other groups ( P < .001). No statistically significant differences were observed among the 4 IOL groups with induction of WTR astigmatism ≤1.0 D. At 0.5 D oblique, the enhanced monofocal group outperformed the extended DOFi group ( P = .014), and at 2.0 D induced oblique astigmatism, it surpassed all other IOL groups. The enhanced monofocal IOL group showed the greatest tolerance to induced ATR astigmatism across all magnitudes. The VLF Full-DOFi IOL group maintained astigmatic tolerance such as standard monofocal, enhanced monofocal, and extended DOFi IOLs up to 2.0 D in WTR and ATR, and 1.5 D in oblique orientations.
conclusionsTIA was not statistically significantly different among the standard monofocal, enhanced monofocal, VLF extended DOFi, and VLF Full-DOFi IOL groups with low to moderate induced WTR astigmatism. The enhanced monofocal IOL provided the greatest tolerance to induced astigmatism, especially under oblique and ATR astigmatic defocus.
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