Visual Acuity Outcomes Of An Enhanced Monofocal Iol Using Different Target Refractions After Routine Phacoemulsification

The main objective of this study is to evaluate the visual outcomes of a monofocal intraocular lens (IOL) with an enhanced intermediate function recently approved by the United States (US) Food and Drug Administration (FDA) in patients with or without astigmatism, when both eyes are targeted for emmetropia and when the non-dominant eye is targeted for mini monovision (-0.75 D) in patients undergoing uneventful routine phacoemulsification.

Carolina Eyecare Physicians, Mt. Pleasant, SC 29464, USA

Prospective, randomized, patient-masked study that includes 74 patients undergoing bilateral cataract surgery with implantation of a monofocal IOL (Eyhance). Patients are randomly assigned to either group A, target refraction plano OU or group B, dominant eye target refraction plano and non-dominant eye -0.75D. At 3 months postoperatively, binocular ETDRS visual acuities (VA) measured uncorrected (UC) at 4m, 66, and 40 cm, best distance corrected (4m) and distance-corrected (DC) at 66 and 40 cm as well as near VA at best distance (BD) and low contrast 10% VA at 4m under photopic & mesopic conditions are evaluated. Statistical analysis comparing both groups is done. A P-value < .05 is considered statistically significant.

A total of 19 patients (8 monovision) have completed the 3 months visit. Mean manifest refractive spherical equivalent (MRSE) in the emmetropic eyes is 0.11D ±0.21 and -0.75D ±0.47 in the non-dominant eye of the mini monovision eyes. Mean UCDVA is not significantly different between the groups (0.025 vs 0.002, P > .05). Mean UCVA at 66 and 40 cm were not statistically significant different between the groups; however, DCVA at 66 and 40 cm as well as BD were significantly better in group B (target -0.75).  No significant differences in low contrast 10% VA at 4 m under photopic or mesopic conditions were seen.

Aiming the non-dominant eye for slight monovision (-0.75D) when using this enhanced monofocal IOL resulted in about 1.5-line improvement in binocular near VA with no appreciable difference in binocular distance vision relative to targeting bilateral emmetropia. This appears to be a feasible alternative to improve near VA when this IOL is bilaterally implanted.