Prospective Fellow-Eye Comparison of a Spherical Monofocal and an Enhanced Monofocal Intraocular Lens in Intermediate and Near Vision.

Purpose: To compare monocular visual performance of a spherical and an enhanced monofocal intraocular lens (IOL) after combined implantation.

Methods: This prospective study comprised 50 patients (100 eyes) with bilateral cataract surgery and implantation of the spherical Sensar AAB00 IOL (Johnson & Johnson Vision) in the dominant eye and the enhanced monofocal Eyhance ICB00 IOL (Johnson & Johnson Vision) in the non-dominant eye. Postoperative assessment compared monocular CDVA, CNVA, DCIVA, DCNVA, low contrast visual acuities, defocus curves, wavefront aberrometry, decentration, tilt, and the 7-item Visual Function Index (VF-7) questionnaire.

Results: Monocular DCIVA at 66 cm (spherical: 0.33 ± 0.13 vs enhanced monofocal: 0.37 ± 0.13 logarithm of the minimum angle of resolution (logMAR), P = .007), DCIVA at 80 cm (spherical: 0.24 ± 0.12 vs enhanced monofocal: 0.31 ± 0.11 logMAR, P < .001), and DCNVA at 40 cm (spherical: 0.49 ± 0.17 vs enhanced monofocal: 0.56 ± 0.13, P = .003) increased significantly with the enhanced monofocal IOL. Similarly, monocular low contrast intermediate (P = .048) and corrected (P = .006) near vision were better in the enhanced monofocal group. Defocus curves from -0.25 to -1.50 D (P < .05) and internal spherical aberrations Z(4,0) (P < .001) differed between the two IOLs. CDVA, decentration, and tilt were comparable (P > .05).

Conclusions: This fellow-eye study demonstrated significant differences between the enhanced monofocal IOL and the spherical IOL. Visual improvements with the enhanced monofocal IOL were modest for both intermediate and near vision. There was no significant difference in distance vision, decentration, or tilt, and higher order aberrations were low. [J Refract Surg. 2025;41(4):e382-e390.].