Visual Outcomes of a Non-Diffractive Extended Depth-of-Focus Intraocular Lens in Patients with Early-Stage Age-Related Macular Degeneration

Abstract

Background/Objectives: Age-related macular degeneration (AMD) is a leading cause of visual impairment in older adults and often coexists with cataracts. The indication of presbyopia-correcting intraocular lenses (IOLs) in these patients remains controversial. This study aimed to evaluate the clinical performance of a non-diffractive extended depth-of-focus (EDOF) IOL (LuxSmart™) compared to a monofocal plus IOL (Tecnis Eyhance™) in cataract patients with early-stage dry AMD. Methods: In this prospective observational study, 41 patients with early-stage AMD underwent bilateral cataract surgery with either LuxSmart™ or Tecnis Eyhance™ IOL implantation, targeting postoperative emmetropia. The eye selected for analysis was the first eye scheduled for surgery. Preoperative and postoperative evaluations included high and low-contrast distance visual acuity, intermediate and near visual acuity, defocus curves, ocular light scatter (halometry), and quality of life assessment (NEI VFQ-25). Postoperative biometric accuracy and refractive outcomes were also analyzed. Results: Both IOLs showed high refractive accuracy, with 100% of eyes within ±0.50 D of target. Postoperative uncorrected distance visual acuity was 0.10 ± 0.06 LogMAR for Eyhance and 0.07 ± 0.02 for LuxSmart (p = 0.06). Low contrast VA at 20% was 0.22 ± 0.11 (Eyhance) and 0.26 ± 0.16 (LuxSmart) (p = 0.49). Depth of focus was approximately 1.75 D for both lenses. Light scatter (LDI) improved postoperatively in both groups with no significant differences (p = 0.54). VFQ-25 scores showed improvement in daily activities, though no changes were observed in driving or mental health domains. Conclusions: Both lenses are safe and effective options for early AMD patients undergoing cataract surgery, providing good functional vision at multiple distances.