Contrast Sensitivity Differences Between Vivity®, Isopure® And Eyhance®: A Prospective, Double-Blind, Randomised Comparison Between Three Enhanced Depth-Of-Focus Intraocular Lenses

to evaluate contrast sensitivity in patients undergoing bilateral same-day cataract surgery with either Vivity®, Isopure® or Eyhance® lenses, adopting a mini-monovision approach. This is a double-blind, randomized, prospective study with a follow-up period of 4 to 6 months.

Single-center study at Vista Alpina Eye Clinic, Visp, Switzerland.
In a double-blind, randomized, prospective design, 280 eyes of 140 patients were implanted bilaterally with Vivity®, Isopure® or Eyhance®, targeting mini-monovision (-0.5D).

A full set of visual acuities, including monocular corrected distance visual acuity (CDVA) and binocular uncorrected distance, intermediate (66cm) and near (40cm) visual acuities (bUDVA, bUIVA and bUNVA), were measured over 4-6 months. Binocular distance-corrected defocus curves were assessed at 1-2 months, spectacle independence (PRSIQ) and contrast sensitivity (CSV-100) at 4-6 months, and photic phenomena and patient satisfaction at 1-2 and 4-6 months.

We here present contrast sensitivity (CSV-100) in photopic and mesopic conditions at 4-6 months, evaluated at 3 cpd, 6 cpd, 12 cpd and 18 cpd.

Vivity® demonstrated the broadest defocus curve (1.85D near defocus at 0.2 logMAR), shortly followed by Eyhance® (1.75D) and Isopure® (1.60D).

Photopic contrast sensitivity on the other hand was worse for Vivity®: a trend was visible at 6 and 12 cpd, reaching statistical significance at 18 cpd:  Vivity® 0.96±0.23 log units, Isopure® 1.09±0.27 (p=0.029) and Eyhance® 1.13±0.25 (p=0.029).

Under mesopic conditions, the differences were more pronounced:

- at 12 cpd:  Vivity® 0.76±0.46 log units, Isopure® 0.96±0.40 (p=0.011) and Eyhance® 1.01±0.41 (p=0.017).

- at 18 cpd:  Vivity® 0.26±0.26 log units, Isopure® 0.42±0.33 (p=0.014) and Eyhance® 0.56±0.36 (p=0.002).

In this study comparing three enhanced depth of focus intraocular lenses — Vivity®, Isopure®, and Eyhance® — distinct optical performance profiles were observed.

Vivity® offered the broadest defocus curve but had compromised contrast sensitivity, especially in low light.

This outcome highlights the importance of considering individual visual needs and preferences when selecting the appropriate lens for patients undergoing cataract surgery.