Aka Report 3: Three-Month Prospective Comparative Assessment Of Objective And Subjective Visual Performance Following Bilateral Implantation Of Non-Diffractive Intraocular Lenses With Extended Range Of Vision Versus Standard Monofocal Control

To prospectively compare objective and patient-reported visual outcomes at 3 months following bilateral implantation of two non-diffractive intraocular lenses (IOLs) with extended range of vision (Eyecryl SERT and RayOne EMV) versus a conventional monofocal aspheric control intraocular lens (CT ASPHINA 409M).

Augenklinik Ahaus - Fachkrankenhaus, Ahaus, North Rhine-Westphalia, Germany.

Prospective, single-center, patient-preference trial enrolling consecutive adults (22–85 years) undergoing bilateral phacoemulsification with IOL implantation. Participants independently selected one of three IOLs after standardized counseling. Assessments at postoperative day 1, week 1, month 1, and month 3 included distance-corrected distance (DCDVA 4 m), intermediate (DCIVA; 80 and 60 cm), and near (DCNVA; 40 cm) visual acuity in logMAR; binocular defocus curves (+1.50 to −2.50 D, 0.50-D steps) with depth of focus (DOF) at 0.1 and 0.2 logMAR thresholds; contrast sensitivity under photopic, mesopic, and mesopic-with-glare conditions; and patient-reported outcomes (VF-14, McAlinden Quality of Vision).

Seventy-seven patients (154 eyes; 42.9% male; mean age 67.0 ± 5.70 years) completed three-month follow-up. CT ASPHINA showed superior DCDVA over Eyecryl SERT (−0.058 logMAR; P = 0.003). At 80 cm, DCIVA was significantly better with Eyecryl SERT (−0.074; P < 0.001) and RayOne EMV (−0.051; P = 0.033) versus CT ASPHINA. Only Eyecryl SERT outperformed CT ASPHINA at 60 cm (DCIVA −0.059; P = 0.006) and 40 cm (DCNVA −0.042; P = 0.028). Negative-side DOF (0.2/0.1 logMAR): Eyecryl SERT −1.61/−1.22 D, RayOne EMV −1.38/−0.97 D, CT ASPHINA −1.17/−0.86 D (P < 0.05). Contrast sensitivity was higher with CT ASPHINA and RayOne EMV. Spectacle independence for intermediate activities was reported 83.3% in Eyecryl SERT group and 94.7% in RayOne EMV group.

Both Eyecryl SERT and RayOne EMV extended intermediate visual performance beyond the monofocal reference at three months. Eyecryl SERT demonstrated the widest depth of focus with significantly better visual acuity at 80, 60, and 40 cm; however, this extended functional range was associated with a modest reduction in distance acuity and contrast sensitivity relative to CT ASPHINA, reflecting the inherent optical trade-off of greater depth of focus extension. RayOne EMV achieved significant intermediate gains at 80 cm, with the highest self-reported spectacle independence, while providing a better contrast sensitivity compared to Eyecryl SERT.