Comparison Of Visual Outcomes Of Enhanced Monofocal Iol And Monofocal Iol With A Myopic Target.

To compare the clinical outcomes of enhanced monofocal IOL (EyhanceⓇ) and monofocal IOL (Tecnis Ⓡ) implantation in cataract patients whose target refraction is myopia.

A total of 68 eyes from 34 patients who had cataract were included. Patients with the following conditions that could affect clinical parameters were excluded: degenerative corneal disease, ectatic corneal disease, lens subluxation/dislocation, or amblyopia. A single surgeon (E. C. K) performed cataract surgery on all patients under topical anesthesia using a CENTURION® (Alcon).

The patients had cataract surgery with implantation of a TECNIS enhanced monofocal IOL (ICB- Group 1: 32 eyes, Johnson & Johnson Vision, Irvine, CA, USA) or TECNIS monofocal IOL (ZCB- Group 2: 36 eyes). All patients underwent a complete ophthalmological examination. Their demographic and perioperative data were recorded. Uncorrected and corrected visual acuities were expressed as logMAR. Manifest refraction, biometry, and keratometry with the IOLMaster partial coherence interferometry device (Carl Zeiss Meditec AG), corneal topography (Pentacam®, Oculus, Germany), and slit lamp examination were examined. The patient’s satisfaction was assessed with a Cataract Type Specification questionnaire at 3 months after cataract surgery.

Postoperative corrected distant visual acuity, uncorrected distant visual acuity and manifest refraction spherical equivalent of two groups were better than preoperative data respectively(P<0.05). There was no statistical difference between two groups(P>0.05). Postoperative corrected intermediate visual acuity and uncorrected intermediate visual acuity at 20cm of group 1(0.09 ± 0.05, 0.12 ± 0.14 logMAR, respectively) were significantly better than group 2(0.21 ± 0.22, 0.22 ± 0.14, respectively)(P<0.05). Defocus curves were measured with distant correction in both groups at 3 months after surgery. Group 1 showed significantly better defocus results at -1.5D and -2.0D of defocus range(corresponding to 66 ~50 cm) compared to group 2(P<0.05)

We thought that the enhanced monofocal IOL had a wider range even in near vision than the monofocal IOL because of the wide depth of focus. So, the enhanced monofocal IOL with myopic target may provide better uncorrected near vision at 20cm, such as when looking at the hand mirror and smartphone than monofocal IOL. So, in this study, the overall satisfaction of group 1 (1.50 ± 0.21) was significantly better than that of group 2 (1.77 ± 0.35) (P<0.05)  Enhanced monofocal IOL with a myopic target showed better corrected intermediate vision and uncorrected very near vision at 20cm compared with monofocal IOL. Overall satisfaction with the enhanced monofocal IOL is also higher than that with monofocal IOL.