The extended depth-of-focus (EDOF) intraocular lens (IOL) is an emerging technology that is designed to improve range of vision, especially at intermediate distances. In this review, we describe the clinical performance of 4 emerging EDOF IOL technologies; that is, small aperture, bioanalogic, diffractive optics, and nondiffractive optical manipulations. The American Academy of Ophthalmology generated a consensus statement for EDOF IOLs that provided benchmarks and recommendations for classifying an implant as an EDOF IOL as well as standardized testing criteria for evaluating performance. Although many types of EDOF technologies are being developed, there are important differences in their performance that require further testing and evaluation.

To evaluate visual function after bilateral implantation of apodized diffractive aspheric multifocal intraocular lenses (IOLs) with a +3.0 diopter addition (add) power. Multicenter study at 5 European sites. Five surgeons prospectively enrolled patients to receive bilateral implantation of AcrySof IQ ReSTOR SN6AD1 IOLs. Assessments included defocus testing, uncorrected and corrected distance visual acuities at various distances, and patient questionnaires. Ninety-three patients were enrolled. The mean distance-corrected visual acuities at far, intermediate, and near distances were significantly better postoperatively. At 6 months, uncorrected visual acuity (logMAR) was -0.03 +/- 0.13 (SD) at 4 m, 0.20 +/- 0.14 at 70 cm, 0.13 +/- 0.15 at 60 cm, 0.05 +/- 0.18 at 50 cm, and 0.04 +/- 0.11 at 40 cm. The mean patient-preferred near distance was 41 +/- 4 cm, at which distance the mean visual acuity was -0.01 +/- 0.11 logMAR. The defocus curve had a plateau of optimum near vision from 40 to 50 cm. Postoperatively, patients reported having minimal to no difficulty with 22 of 27 visual disturbances or visual activities; the other 5 items were ranked minimally to moderately difficult. The mean patient satisfaction with vision was 8.3 +/- 1.6 (out of 10); 88% of patients were spectacle independent. Bilateral apodized diffractive aspheric multifocal IOLs with a +3.0 D add provided a broad range of optimum near vision, good intermediate visual acuity, and low rates of visual disturbances. Patients were highly satisfied with their vision, and 88% were spectacle independent.