Impact Of Residual Refractive Error On Visual Acuity In Eyes Implanted With A Full Visual Range Intraocular Lens

As small postoperative refractive deviations may influence acuity, quantifying their impact may support optimisation of full visual range (FVR) intraocular lens (IOL) performance. This study assessed real‑world visual acuity outcomes with a FVR IOL, stratified by residual refractive error.

In this multicenter, cross-sectional retrospective study, 10 providers (9 USA, 1 Canada) contributed cases of patients who underwent cataract surgery with implantation of a FVR IOL. Patients were followed for up to 6 months.

On‑label enVista ENVY IOL electronic medical record cases were provided using a standardised case report forms of patient cases implanted with the enVista ENVY (EN) non-toric IOL following cataract surgery. Outcome measures included postoperative monocular uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA). In this subanalysis, outcomes were stratified by residual refractive error (sphere, cylinder and MRSE) in 0.25 D groups. Follow-up was ≥6 months.

A total of 144 eyes from 94 patients were included in this analysis. In eyes implanted with the EN IOL and a residual sphere of –0.5 D, UDVA, UIVA, and near visual acuity UNVA of ≤20/25 was achieved in 25%, 100%, and 100% of cases, respectively. With a residual sphere of –0.25 D, these visual acuity levels were attained in 57% for UDVA, 100% for UIVA, and 71% for UNVA. In the emmetropic group (0.00 D), the proportions of eyes achieving ≤20/25 were 70% for UDVA, 71% for UIVA, and 44% for UNVA. Eyes with a residual sphere of ≥+0.25 D also demonstrated favorable outcomes, with more than 80% achieving ≤20/25 UDVA, more than 82% achieving ≤20/25 UIVA, and more than 76% achieving ≤20/25 UNVA.

The EN IOL delivered strong visual performance across all distances in the majority of patients. Eyes with minimal residual refractive error (±0.25 D), whether cylinder or MRSE, demonstrated better or comparable uncorrected visual acuity across all distances. These findings highlight the importance of precise refractive targeting when implanting FVR IOLs.