Real-World Outcomes Of Bilateral Implantation Of An Advanced Monofocal Tecnis Eyhance® Versus Clareon®: A Head-To-Head Comparative Study

Standard monofocal intraocular lens (IOL) implantation may result in dissatisfaction due to compromised intermediate and near vision. Advanced monofocal IOLs, such as the TECNIS Eyhance®, aim to extend the range of vision while preserving excellent distance visual acuity and a favourable optical side-effect profile. This study compares the real-world visual outcomes of bilateral implantation of both IOLs using a standardised mini-monovision protocol.

Department of Ophthalmology, Unidade Local de Saúde de Gaia e Espinho, Vila Nova de Gaia, Portugal.

Prospective controlled comparative study (head to head) of patients undergoing bilateral cataract surgery with either TECNIS Eyhance® (n=42) or Clareon® monofocal (n=32) IOL implantation. Identical protocols were applied: the dominant eye targeted to emmetropia and the non-dominant eye to −0.50 D (mini-monovision). Exclusion criteria: corneal astigmatism >1 D, high myopia, or concomitant ocular pathology. Post-operative evaluation (1-2 months after second-eye surgery) included monocular and binocular best-corrected (BC) and uncorrected (U) visual acuity (VA) for distance (D), intermediate (I) and near (N). Visual symptoms were assessed using the PRVSQv2 questionnaire.

Eyhance group: 42 patients (29 female; age 72.4±5.8 years). Clareon group: 32 patients (10 female; age 74.9±6.0 years). Binocular UDVA was equivalent (0.01±0.05 vs 0.01±0.05 logMAR; p=0.66), with 97.6% and 100% achieving UDVA ≤0.10 logMAR, respectively. BCVA was also comparable (−0.03±0.04 vs −0.04±0.06; p=0.31). Significant differences favoured Eyhance for intermediate and near vision: UIVA 0.08±0.12 vs 0.16±0.11 (p=0.010), DCIVA 0.12±0.12 vs 0.24±0.08 (p=0.001), UNVA 0.27±0.15 vs 0.40±0.16 (p=0.010), DCNVA 0.32±0.14 vs 0.46±0.13 logMAR (p=0.002). In the Eyhance group, 81% achieved UIVA ≤0.10 logMAR vs 50% in the Clareon group. Complains about positive dysphotopsias on PRVSQv2 were irrelevant.

Both the TECNIS Eyhance® and Clareon® IOLs deliver excellent and equivalent UDVA when implanted using a mini-monovision protocol. However, the TECNIS Eyhance® IOL demonstrated significantly superior intermediate and near visual outcomes across all measured parameters, suggesting a clinically meaningful advantage in extending the functional range of vision. These findings support the preferential use of the TECNIS Eyhance® IOL in patients prioritising enhanced intermediate and near visual performance following cataract surgery.