A comparative evaluation of visual, refractive, and patient-reported outcomes of four premium intraocular lenses.

Purpose: Compare visual, refractive, optical performance, and patient-reported measures in cases implanted with one premium IOL: Precizon Presbyopic NVA, AT Lisa Tri 839, Acrysof IQ Vivity, and TECNIS Eyhance ICB00.

Methods: Prospective, comparative clinical study of 100 eyes of 100 patients: Visual acuity, refraction, slitlamp biomicroscopy, defocus curve, ocular aberrations, point spread function, pupil size, contrast sensitivity, and quality of vision were evaluated at 6 months. 79 eyes with Vivity were analyzed for correlations between postoperative near vision and preoperative/postoperative parameters.

Results: Postoperative uncorrected distance visual acuity for Precizon, Vivity, AT Lisa, and Eyhance were 0.04, 0.11, 0.02, and 0.07 logMAR, respectively. AT Lisa showed superior aberrometric performance and defocus curve with better near vision. Vivity had better retinal image quality and contrast, exceling in intermediate vision. Precizon excelled in near vision. Vivity had better Quality of vision scores; where 16% achieved uncorrected near vision ≤ 0.1, 72% > 0.1 to < 0.4, and 8% ≥ 0.4 logMAR, with no significant predictors.

Conclusions: Our findings suggest that the varied performance of premium IOLs may benefit from personalized selection based on patient goals and expectations. Differences in subjective visual quality highlight the need to manage expectations, particularly with EDOF lenses. However, conclusions should be interpreted with caution due to methodological limitations.