Visual Performance and Subjective Outcomes with Enhanced Monofocal Intraocular Lens Implantation Targeted for Emmetropia or Modest Monovision.

Abstract

Purpose: To determine the visual performance and patient reported outcomes after bilateral implantation of an enhanced monofocal intraocular lens (IOL) (RayOne EMV RAO200E) targeted for emmetropia or modest monovision.

Patients and methods: This was a prospective, single-centre, comparative, interventional study. Patients were divided into two groups and targeted for bilateral emmetropia or modest monovision (-1.50 D in the near eye). Manifest refraction, monocular uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected and distance-corrected intermediate visual acuity (UIVA and DCIVA), uncorrected and distance-corrected near visual acuity (UNVA and DCNVA), and monocular and binocular defocus curves under photopic and mesopic conditions were measured at 1-month post-surgery. The Catquest 9-SF questionnaire was administered to assess patient reported visual outcomes and quality of life.

Results: 60 patients were enrolled. For the emmetropia group (n = 30), the mean logMAR UDVA, UIVA and UNVA were 0.16±0.13, 0.35±0.12 and 0.50±0.15. In the monovision group (n = 30), the values for the distance eyes were 0.13±0.11, 0.40±0.11 and 0.56±0.13; and for the near eyes 0.41±0.21, 0.27±0.16 and 0.34±0.13. Binocular defocus curves showed similar distance visual acuity but better visual acuity in the monovision group from -1.00 D to -4.00 D and -1.00 D to -3.50 D defocus under photopic and mesopic conditions respectively (p < 0.05). The defocus range (logMAR 0.2 or better) was 1.3 D for the bilateral emmetropia group and 2.5 D for the monovision group. 90% (emmetropia group) and 96% (monovision group) of patients were very or fairly satisfied with their vision, with the monovision group reporting better performance for intermediate and near tasks.

Conclusion: Patients targeted for bilateral emmetropia achieved good functional intermediate vision, while those with modest monovision experienced enhanced intermediate and near vision. Overall, patients reported high satisfaction and good visual performance when implanted with the enhanced monofocal IOL.