Optical Performance and Refractive Outcomes of a New Monofocal Intraocular Lens With Intermediate Optimized Optics.

Purpose: To evaluate refractive outcomes, defocus curve, wavefront analysis, and automated refraction of a novel monofocal intraocular lens (IOL) with higher order aspheric coefficients and controlled curvature change.

Methods: This prospective observational study included 29 eyes of 29 consecutive patients with healthy eyes and normal visual potential who had undergone cataract surgery and implantation of the enVista Aspire IOL (Bausch + Lomb, Inc). Outcome measures included monocular uncorrected (UDVA), corrected (CDVA), distance-corrected intermediate (DCIVA) (at 66 cm), and distance-corrected near (DCNVA) (at 40 cm) visual acuity, defocus curve, wavefront analysis, mean refractive prediction error, and automated and manifest (MRSE) refraction spherical equivalent.

Results: Mean UDVA was 20/22, with 93.1% of eyes having 20/25 or better. Mean CDVA was 20/20, with all eyes having 20/25 or better. Mean DCIVA was 20/34, with 90% of eyes having 20/40 or better. Mean DCNVA was 20/38, with 83% of eyes having 20/40 or better. The monocular defocus curve demonstrated approximately 1.50 diopters (D) depth of focus for visual acuity of 0.2 logarithm of the minimum angle of resolution or better. Postoperative mean MRSE was close to emmetropia (0.02 ± 0.29 D), and 96.6% of eyes were within ±0.50 D. Automated refraction measured with ray-tracing, dynamic sciascopy, and Hartmann-Shack devices were within ±0.25 D of the subjective refraction. The postoperative ocular 4th-order spherical aberration measured with Hartmann-Shack aberrometer was 0.08 and 0.15 µm for a 4.5- and 6-mm pupil, respectively.

Conclusions: Implantation of a new enhanced monofocal IOL demonstrated useful near and intermediate vision while maintaining excellent distance acuity. Wavefront analysis revealed minimal postoperative spherical aberration, and the automated refraction was near emmetropia.