Intermediate Contrast Sensitivity After Enhanced Monofocal Toric Versus Conventional Monofocal Toric Iol Implantation

To compare intermediate-range contrast sensitivity after implantation of an enhanced monofocal (EM) toric intraocular lens (IOL) versus a conventional monofocal toric IOL and to evaluate its relevance as a measure of intermediate visual function.

This retrospective comparative study included 64 eyes of 32 patients with corneal astigmatism ≥0.75 D implanted with an EM toric IOL (TECNIS Eyhance Toric™, Johnson & Johnson Vision) and 20 eyes of 10 patients implanted with a conventional monofocal toric IOL (Clareon Toric™, Alcon). All procedures were performed using digital image-guided axis alignment.

At 1 month postoperatively, uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual acuity (UIVA) were measured (logMAR). Distance contrast sensitivity was assessed under photopic conditions using area under the log contrast sensitivity function (AULCSF). Intermediate contrast sensitivity was evaluated under photopic and mesopic conditions, with and without glare.

UDVA (−0.07 vs −0.06 logMAR; p=0.25), UIVA (0.12 vs 0.18 logMAR; p=0.13), and photopic distance AULCSF (p=0.17) did not differ significantly between groups.

However, the EM toric group demonstrated significantly higher intermediate AULCSF under photopic conditions with glare (1.76 vs 1.59; p=0.03) and mesopic conditions without glare (1.62 vs 1.42; p=0.02).

Despite similar intermediate visual acuity, enhanced monofocal toric IOL implantation resulted in superior intermediate contrast sensitivity. These results indicate that contrast sensitivity assessment may better reflect real-world intermediate functional vision than visual acuity alone and may provide additional insight when evaluating enhanced monofocal optics.