METHODS:This prospective cohort, multicenter study enrolled patients with cataract who underwent cataract phacoemulsification with IOL implantation at three hospitals between October 2024 and June 2025. Patients were divided into the AMEUH group and the ZXR00 group according to the implanted IOL. The AMEUH group included patients implanted with diffractive extended depth-of-focus IOL, and the ZXR00 group included patients implanted with the Tecnis Symfony IOL. At 6 mo postoperatively, ocular biometric parameters, photopic uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), corrected distance visual acuity(CDVA), distance-corrected intermediate visual acuity(DCIVA), and distance-corrected near visual acuity(DCNVA); mesopic CDVA, DCIVA, and DCNVA, defocus curves, manifest refraction, contrast sensitivity, adverse visual symptoms, spectacle independence, patient satisfaction, and intraocular pressure were compared between the two groups.

RESULTS:A total of 83 patients(83 eyes)were included in this study, including 31 males(31 eyes)and 52 females(52 eyes), with a mean age of 63.18±10.30 y. The AMEUH group included 41 patients(41 eyes), aged 67.00(60.00, 72.00)y, including 13 males and 28 females. The ZXR00 group included 42 patients(42 eyes), aged 62.00(57.50, 69.00)y, including 18 males and 24 females. The 77 patients completed 6 mo postoperative follow up, with 6 patients lost to follow up(3 from the AMEUH group and 3 from the ZXR00 group). There were no significant differences in ocular biometric parameters between the two groups postoperative 6 mo(all P>0.05). No significant differences were observed in photopic UDVA, UIVA, UNVA, CDVA, and DCIVA, or in mesopic CDVA and DCIVA between the two groups(all P>0.05). However,photopic and mesopic DCNVA in the AMEUH group were significantly better than in the ZXR00 group(both P<0.05). The effective depth-of-focus in the AMEUH group was increased by 0.5 D compared with the ZXR00 group. Significant differences were observed in manifest refraction between the two groups(P<0.05). Under specific lighting conditions and spatial frequencies, contrast sensitivity in the AMEUH group was significantly better than in the ZXR00 group(all P<0.05). The incidences of glare, halos, and blurred vision in the AMEUH group were all significantly lower than in the ZXR00 group(all P<0.05). There were no significant differences in spectacle independence for distance, intermediate, and near vision, or in patient satisfaction for distance and intermediate vision between the two groups(all P>0.05). However, patient satisfaction for near vision in the AMEUH group was significantly higher than in the ZXR00 group(P<0.05).

CONCLUSION:The diffractive extended depth-of-focus IOL AMEUH further extends the depth-of-focus through a higher-order aspheric optical design based on a diffractive design, providing comparable efficacy to the Symfony IOL in improving distance and intermediate vision. Meanwhile, benefiting from its higher add power, it provides superior near visual performance, and reduces spectacle dependence. The AMEUH IOL is associated with a lower incidence of postoperative adverse visual symptoms, as well as favorable safety, and high patient satisfaction.