Comparison of visual performance among three higher-order aspheric enhanced monofocal intraocular lenses and a standard aspheric monofocal lens.

Purpose: To compare visual performance among three types of higher-order aspheric enhanced monofocal intraocular lenses (IOL) and a standard aspheric monofocal IOL.

Setting: Hayashi Eye Hospital, Fukuoka, Japan.

Design: Randomized comparative study.

Methods: Three hundred forty-four eyes of 172 patients scheduled for phacoemulsification were randomly assigned to one of four groups according to the IOL type: three types of enhanced monofocal IOL, 1) Eyhance, 2) Impress, and 3) NSP-3, and a standard monofocal IOL, 4) Tecnis monofocal. At 2 months postoperatively, monocular and binocular distance-corrected visual acuity (VA) from far to near simulated distances, photopic and mesopic contrast VA, and degree of halo and glare symptoms were measured and compared among groups.

Results: Mean monocular and binocular distance-corrected intermediate VA at 0.5, 0.7, and 1.0 m was essentially better in the three enhanced monofocal IOL groups than in the standard monofocal IOL group (P ≤ .04), whereas mean far and near distance-corrected VAs at 0.3, 2.0, 3.0, 5.0, and ∞ m did not differ significantly among the four groups. Mean photopic and mesopic contrast VA and the size and intensity of halo and glare symptoms did not differ significantly among groups.

Conclusions: The three enhanced monofocal IOL types evaluated provided significantly better intermediate VA than a standard monofocal IOL with no significant deterioration in contrast sensitivity or photic symptoms. All visual performance test results examined were comparable among the three enhanced monofocal IOL types, suggesting that enhanced monofocal IOLs can serve as a replacement for standard monofocal IOLs.