Real-world study of enVista Aspire IOL reports over 90% patient satisfaction

At the 44th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) in London, Cathleen McCabe, MD, presented real-world data from a US study of the enVista Aspire intraocular lens (IOL; Bausch + Lomb). McCabe described it as a partial depth-of-field enhanced monofocal lens. She discloses that she is a consultant for Bausch + Lomb.

Study design

The 57-site study enrolled 310 patients who underwent bilateral implantation. Patients were selected so that they had no other comorbidities, and anyone who had a complication during surgery was excluded.

Distance and intermediate outcomes

About 93% of patients achieved 20/32 or better monocular distance vision. With binocular summation, this rose to 96%.

“But I think what we really care about with these partial depth-of-field enhanced monofocal lenses is the ‘enhanced’ part,” McCabe said. At intermediate distance, more than 70% of patients achieved 20/32 uncorrected vision.

Patient-reported outcomes

Patient satisfaction with vision exceeded 90%. More than 50% of patients reported that they could look at a computer and read their own handwriting without glasses.

McCabe said the most surprising finding was the number of patients who reported doing many near tasks with an enhanced monofocal design. “That’s just not something I would ever discuss with a patient,” she said. “In fact, I would tell them they won’t have that functionality.”

Safety

The dysphotopsia rate was low, which McCabe said was consistent with a monofocal-type optic. The study recorded no treatment-related or device-related complications. A few lenses were damaged during insertion and replaced, which McCabe attributed to the inserter rather than the lens.

Candidate selection

McCabe described the lens as an option for patients without pathology. She added that it may also suit challenging patients who might not be candidates for a diffractive optic, such as those with early signs of progressive disease. “In my opinion, there’s really no patient who wouldn’t be a good candidate for this lens,” she said.

Platform and toric correction

The lens is built on the enVista platform. McCabe noted that the material is clear and glistening-free and that the haptics provide rotational stability. She said achieving less than 0.5 dioptres (D) of residual astigmatism is critical for quality of vision and patient satisfaction. The toric version is available in a 0.9 D power, which she said treats approximately 0.64 D at the corneal plane. This allows surgeons to target low levels of astigmatism with greater precision.