Comparative analysis of visual outcome with 3 intraocular lenses: monofocal, enhanced monofocal, and extended depth of focus

Purpose: To compare the visual performance, spectacle independence, and subjective visual quality of 3 intraocular lenses (IOLs): monofocal, enhanced monofocal, and extended depth of focus. Setting: Ophthalmology Department, San Raffaele Scientific Institute, Milan, Italy. Design: Prospective case series. Methods: Patients without ocular comorbidities and corneal astigmatism <0.75 diopters (D) undergoing cataract surgery with bilateral implantation of monofocal Tecnis ZCB00, enhanced monofocal Eyhance ICB00, and extended depth-of-focus Symfony ZXR00 IOLs were included. 6 months postoperatively, the following parameters were analyzed: subjective and objective refraction; monocular and binocular corrected distance (4 m) and uncorrected distance (UDVA) visual acuity; corrected distance, intermediate (66 cm), and near (40 cm) visual acuities, as well as uncorrected intermediate (UIVA) and uncorrected near (UNVA) visual acuities; photopic contrast sensitivity; binocular defocus curve; halo and glare perception; and spectacle independence. Results: 150 eyes of 75 patients (25 patients per IOL group) were evaluated. Monocular and binocular UDVA was excellent in all 3 groups. Eyhance achieved binocular UIVA similar to that of Symfony, the latter showing the highest binocular UNVA. The defocus curves at -1.0 D were equivalent for both Eyhance and Symfony, whereas contrast sensitivity was similar in all 3 groups. The Eyhance spectacle independence score was comparable with Symfony for intermediate distance activities, the latter, however, achieved the worst results for halos and glare. Conclusions: Enhanced monofocal Eyhance was not inferior to Symfony as regards intermediate distance visual outcome and spectacle independence, and also provided lower subjective perception of halos and glare. Copyright (c) 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS