Comparative analysis of visual outcome with 3 intraocular lenses: monofocal, enhanced monofocal, and extended depth of focus

Abstract

Purpose: To compare the visual performance, spectacle independence, and subjective visual quality of 3 intraocular lenses (IOLs): monofocal, enhanced monofocal, and extended depth of focus.

Setting: Ophthalmology Department, San Raffaele Scientific Institute, Milan, Italy.

Design: Prospective case series.

Methods: Patients without ocular comorbidities and corneal astigmatism <0.75 diopters (D) undergoing cataract surgery with bilateral implantation of monofocal Tecnis ZCB00, enhanced monofocal Eyhance ICB00, and extended depth-of-focus Symfony ZXR00 IOLs were included. 6 months postoperatively, the following parameters were analyzed: subjective and objective refraction; monocular and binocular corrected distance (4 m) and uncorrected distance (UDVA) visual acuity; corrected distance, intermediate (66 cm), and near (40 cm) visual acuities, as well as uncorrected intermediate (UIVA) and uncorrected near (UNVA) visual acuities; photopic contrast sensitivity; binocular defocus curve; halo and glare perception; and spectacle independence.

Results: 150 eyes of 75 patients (25 patients per IOL group) were evaluated. Monocular and binocular UDVA was excellent in all 3 groups. Eyhance achieved binocular UIVA similar to that of Symfony, the latter showing the highest binocular UNVA. The defocus curves at -1.0 D were equivalent for both Eyhance and Symfony, whereas contrast sensitivity was similar in all 3 groups. The Eyhance spectacle independence score was comparable with Symfony for intermediate distance activities, the latter, however, achieved the worst results for halos and glare.

Conclusions: Enhanced monofocal Eyhance was not inferior to Symfony as regards intermediate distance visual outcome and spectacle independence, and also provided lower subjective perception of halos and glare.