Systematic Review And Meta-Analysis Of Enhanced Versus Monofocal Intraocular Lenses In Cataract Surgery
Published 2025 - 43rd Congress of the ESCRS
Reference: PO379 | Type: Free paper | DOI: 10.82333/e28h-6934
Authors: Joaquín Fernández* 1 , Noemí Burguera 1 , Marina Rodríguez-Calvo-de-Mora 2 , Carlos Rocha-de-Lossada 3 , Manuel Rodríguez-Vallejo 1
1Department of Ophthalmology ,Vithas,Almería,Spain, 2Department of Ophthalmology ,Vithas,Almería,Spain;Department of Ophthalmology ,Vithas,Málaga,Spain;Department of Ophthalmology,Hospital Regional Universitario de Málaga,Málaga,Spain, 3Department of Ophthalmology ,Vithas,Málaga,Spain;Department of Ophthalmology ,Vithas,Almería,Spain;Department of Ophthalmology,Hospital Regional Universitario de Málaga,Málaga,Spain;Department of Ophthalmology,Universidad de Sevilla,Sevilla,Spain
Purpose
to compare the visual and patient-reported outcomes of Eyhance vs. other monofocal intraocular lenses (IOLs) in cataract patients.
Setting
Qvision, Ophthalmology Department, VITHAS Almería Hospital
Methods
A systematic search of Medline (PubMed), Embase (Ovid), and trial registries (clinicaltrials.gov, WHO) identified randomized and non-randomized comparison studies (2019-2024). Studies included binocular cataract surgeries across all comorbidities, IOL models, and surgical variations. Primary outcomes were monocular distance-corrected visual acuities (CDVA, DCIVA, DCNVA), defocus curves (DC), and contrast sensitivity function (CSF). Secondary outcomes included binocular visual acuities, contrast sensitivity, and patient-reported measures like spectacle independence (SI), photic phenomena (PP) and positive dysphotopsia (PD). Risk of bias was assessed using RoB 2.0 and ROBINS-I. A random effects model was used for meta-analysis.
Results
A total of 31 studies met the eligibility criteria. No clinically relevant differences in CDVA existed between Eyhance and other IOLs. However, significant differences favoring Eyhance were found for DCIVA (-0.11 logMAR, CI95%: -0.13 to -0.10) and DCNVA (-0.12 logMAR, CI95%: -0.17 to -0.07). These results were corroborated by binocular uncorrected VAs and DCs. Additionally, no significant differences were observed in CSF or PP and PD, with low- and moderate-certainty evidence, respectively. SI at intermediate distance significantly favored Eyhance, with an odds ratio of 7.85 (CI95%: 4.08 to 15.09), though no differences were observed for distance SI. Near-distance SI also favored enhanced IOLs, though with low-certainty evidence.
Conclusions
This meta-analysis shows high-certainty evidence that Eyhance IOL improves intermediate and near visual acuity compared to conventional monofocal IOLs. However, evidence for contrast sensitivity and patient-reported outcomes is moderate or low. Few studies exist for other new enhanced monofocal IOLs, and more research is needed to confirm their outcomes in comparison to Eyhance.