Comparison of visual performance between three enhanced monofocal intraocular lenses under different refractive targets.

Abstract

Purpose: To compare the monocular uncorrected visual acuity (UCVA) and contrast sensitivity (CS) of three enhanced monofocal intraocular lenses (IOLs) under emmetropic and mild myopic refractive targets.

Study design: Single-center retrospective observational study.

Methods: Among 198 patients (244 eyes) who underwent uneventful cataract surgery with enhanced monofocal IOL implantation (Tecnis Eyhance [DIB00V, E group], Vivinex Impress [XY1-EM, I group], NIDEK NSP-3 [N group]) with emmetropia or mild myopia (-1.00D), refractive targets, monocular UCVA at six different distances (5, 1, 70, 50, 40, and 30 cm) and CS with and without glare were assessed 1 month postoperatively and compared using the Kruskal-Wallis test followed by the Steel-Dwass post-hoc test.

Results: In the emmetropic group, UCVA for all IOLs achieved ≤ 0.2 logMAR from 5 m to 50 cm, with significantly better UCVA at 5 m in the E than I group (p = 0.0300) and at 50 cm in the I than N group (p = 0.0242). For mild myopia, the N group achieved better UCVA at 5 m (p = 0.0066), the I group showed superior near-visual acuity at 30 cm than the E group (p = 0.0457), and UCVA for all IOLs achieved ≤ 0.2 logMAR from 1 m to 40 cm, with the highest CS at 6, 12, and 18 cycles per degree, with and without glare, in the E group. These findings suggest that combining enhanced monofocal IOLs with mild myopic targeting (-1.0 D) may optimize functional vision for everyday activities, particularly in older adults who rely on safe intermediate and near vision in daily life.

Conclusions: All IOLs showed good UCVA. The E, I, and N groups demonstrated balanced visual performance, with superior contrast sensitivity, superior near-to-intermediate vision, and superior distance vision, respectively.