Comparative visual outcomes of extended depth-of-focus intraocular lenses after cataract surgery: a Bayesian network meta-analysis

Résumé fourni par la source

Extended depth-of-focus (EDOF) intraocular lenses (IOLs) are designed to enhance functional vision across distances while reducing dysphotopsia after cataract surgery. However, direct comparative evidence among different EDOF optical designs remains limited. A systematic review and Bayesian network meta-analysis of randomized controlled trials was conducted. Embase, Ovid-Medline, and the Cochrane Central Register of Controlled Trials were searched from inception to February 24, 2024. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Mean differences (MDs) with 95% credible intervals (CrIs) were estimated using a Bayesian random-effects model. Outcomes included visual acuity and patient-reported visual disturbances. Five randomized controlled trials involving 524 participants (1048 eyes) were included. For uncorrected distance visual acuity, IC-8 showed numerically more favorable estimates than LARA (MD = − 0.06 logMAR; 95% CrI − 0.21 to 0.08), SYMFONY (MD = − 0.06; 95% CrI − 0.18 to 0.06), and VIVITY (MD = − 0.07; 95% CrI − 0.20 to 0.06). For intermediate and near visual acuity, LARA showed numerically more favorable estimates among the lenses included in these analyses. However, most credible intervals crossed the null value, indicating substantial statistical uncertainty. Visual disturbance outcomes were summarized descriptively because of heterogeneous questionnaires and reporting formats. This exploratory Bayesian network meta-analysis identified numerical trends among currently studied EDOF IOLs, but the available evidence does not establish the comparative superiority of any lens. The findings may inform cautious, individualized patient discussions and future research, while IOL selection should remain guided by patient-specific visual needs, ocular condition, tolerance of visual disturbances, and local accessibility.

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