Search Results (45)

Background/Objectives: The objective of this study is to compare the optical and visual quality provided by the advanced monofocal intraocular lens (IOL) ISOPure and the standard monofocal IOL MicroPure in cataract patients, using objective and subjective assessments. Methods: This prospective, single-blind clinical study includes 28 patients with cataracts, bilaterally implanted with either the ISOPure or MicroPure IOL. Eligible eyes had no ocular comorbidities and regular corneal astigmatism ≤ 1.00 D. Three months postoperatively, uncorrected distance and intermediate (UDVA, UIVA) and corrected distance and intermediate (CDVA, DCIVA) visual acuities were measured at 4 m, 80 cm, and 66 cm under photopic (85 cd/m²) and mesopic (3.5 cd/m²) conditions. Photic phenomena, including halo and glare, were evaluated. Objective optical quality was assessed using Objective Scattering Index (OSI), Modulation Transfer Function (MTF), Strehl Ratio (SR), and ocular aberrations. Subjective patient satisfaction was evaluated using Quality of Vision (QoV) and Catquest-9SF questionnaires. Results: Under photopic conditions, logMAR DCIVA at 80 cm, UIVA at 66 cm, and DCIVA at 66 cm were 0.18 ± 0.06, 0.25 ± 0.12, and 0.20 ± 0.13, respectively, for ISOPure, and 0.22 ± 0.06, 0.30 ± 0.09, and 0.25 ± 0.09 for MicroPure (p = 0.05, 0.02, and 0.05, respectively). No significant differences were observed in halo/glare size or intensity, OSI, MTF, or SR. However, statistically significant differences were found in higher-order total aberrations for pupil sizes of 3.0, 4.0 mm, and 5.0 mm. Questionnaires indicated greater satisfaction and functional intermediate vision with ISOPure. Conclusions: The ISOPure IOL offers superior intermediate vision without compromising distance vision, delivering a balanced combination of optical quality, functional performance, and patient satisfaction. Full article

Background/Objectives: Age-related macular degeneration (AMD) is a leading cause of visual impairment in older adults and often coexists with cataracts. The indication of presbyopia-correcting intraocular lenses (IOLs) in these patients remains controversial. This study aimed to evaluate the clinical performance of a non-diffractive extended depth-of-focus (EDOF) IOL (LuxSmart™) compared to a monofocal plus IOL (Tecnis Eyhance™) in cataract patients with early-stage dry AMD. Methods: In this prospective observational study, 41 patients with early-stage AMD underwent bilateral cataract surgery with either LuxSmart™ or Tecnis Eyhance™ IOL implantation, targeting postoperative emmetropia. The eye selected for analysis was the first eye scheduled for surgery. Preoperative and postoperative evaluations included high and low-contrast distance visual acuity, intermediate and near visual acuity, defocus curves, ocular light scatter (halometry), and quality of life assessment (NEI VFQ-25). Postoperative biometric accuracy and refractive outcomes were also analyzed. Results: Both IOLs showed high refractive accuracy, with 100% of eyes within ±0.50 D of target. Postoperative uncorrected distance visual acuity was 0.10 ± 0.06 LogMAR for Eyhance and 0.07 ± 0.02 for LuxSmart (p = 0.06). Low contrast VA at 20% was 0.22 ± 0.11 (Eyhance) and 0.26 ± 0.16 (LuxSmart) (p = 0.49). Depth of focus was approximately 1.75 D for both lenses. Light scatter (LDI) improved postoperatively in both groups with no significant differences (p = 0.54). VFQ-25 scores showed improvement in daily activities, though no changes were observed in driving or mental health domains. Conclusions: Both lenses are safe and effective options for early AMD patients undergoing cataract surgery, providing good functional vision at multiple distances Full article

Background/Objectives: The Tecnis Eyhance is an enhanced monofocal intraocular lens (IOL) designed to improve intermediate vision without compromising distance clarity or increasing the incidence of photic phenomena. Although short-term results have been encouraging, long-term data remain limited. This study presents the 5-year follow-up of a previously published 6-month clinical evaluation, aiming to assess the stability of visual, optical, and patient-reported outcomes over time. Methods: A single-center retrospective study of 18 patients (36 eyes) undergoing bilateral Tecnis Eyhance IOL implantation was conducted. The same cohort from the original 6-month study was re-evaluated after a mean follow-up of 5 years. Visual acuity (distance, intermediate, near), defocus curves, contrast sensitivity, optical quality, effective lens position (ELP), halo size, and patient-reported measures were assessed. Results: Visual acuity remained stable across all distances, with binocular uncorrected intermediate visual acuity (UIVA) ≤ 0.2 logMAR in all patients. No significant changes were observed in optical quality parameters or contrast sensitivity. ELP remained consistent over time (p = 0.298), and posterior capsule opacification (PCO) requiring Nd:YAG capsulotomy developed in 5% of the eyes. Halo size was mild, and subjective glare perception did not increase. Spectacle independence remained high for distance (100%) and intermediate (more than 75%) tasks. Conclusions: This 5-year follow-up study confirms the long-term stability and effectiveness of the Tecnis Eyhance IOL. These findings support its long-term use as a stable monofocal IOL with enhanced intermediate function. Full article

Background: Spectacle independence is a key goal in refractive lens exchange (RLE), especially in younger, high-expectation patients. This study evaluates a novel extended monovision approach combining a monofocal aspheric intraocular lens (IOL) in the dominant eye with a rotationally asymmetric bifocal extended-depth-of-focus (EDOF) IOL in the non-dominant eye. The strategy aims to optimize full-range visual performance while minimizing photic phenomena. Methods: In this retrospective cohort study, presbyopic patients underwent bilateral RLE with a monofocal IOL (Hoya Vivinex XC1-SP; target: 0 diopters [D]) in the dominant eye and a rotationally asymmetric bifocal EDOF IOL (LENTIS LS-313 MF15; addition: +1.5 D; target: −1.25 D) in the non-dominant eye. Uncorrected distance visual acuity (UDVA, at 6 m), uncorrected intermediate visual acuity (UIVA, at 66 cm), and uncorrected near visual acuity (UNVA, at 36 cm) were assessed. Additional evaluations included binocular defocus curves, contrast sensitivity, stereoacuity, and photic phenomena. Spectacle independence and satisfaction were measured using the PRSIQ and NEI-RQL-42 questionnaires. Results: A total of 38 patients (76 eyes) were included. The mean postoperative binocular UDVA, UIVA, and UNVA were −0.03 ± 0.08, −0.08 ± 0.09, and 0.04 ± 0.08 logMAR, respectively. The defocus curve peaked at 0.0 D (6 m) with a mean visual acuity of −0.03 ± 0.08 logMAR. Functional vision better than 0.2 logMAR extended over defocus steps from +1.00 to −3.25 D. All patients were spectacle-independent for distance and intermediate vision, and 84% reported complete spectacle independence. Contrast sensitivity was within normal limits for age. Minimal photic phenomena were reported, and stereoacuity was preserved in 97% of patients (≤100 arcseconds). Conclusions: This innovative extended monovision approach, combining two different IOLs in a mini-monovision setup, provides excellent uncorrected visual acuity at all distances, high spectacle independence, and minimal side effects. It represents a compelling alternative to multifocal IOL implantation in presbyopic RLE candidates. Full article

Functional Optical Balance (FOB) is a novel personalized strategy for intraocular lens (IOL) selection in cataract surgery, designed to reconcile the trade-off between optical quality and spectacle independence. FOB is a core concept aiming to maximize visual performance by treating the two eyes as a synergistic pair. One eye (often the dominant eye) is optimized for pristine optical quality (typically distance vision with a high-contrast monofocal or low-add IOL). In contrast, the fellow eye is optimized for extended depth of focus and pseudoaccommodation (using an extended depth-of-focus or multifocal/trifocal IOL) to reduce dependence on glasses. This review introduces the rationale and theoretical basis for FOB, including the interplay of depth of focus and optical aberrations, binocular summation, ocular dominance, and neuroadaptation. We discuss the clinical implementation of FOB: how the first-eye results guide the second-eye IOL choice in a tailored “mix-and-match” approach, as well as practical workflow considerations such as patient selection, ocular measurements, and decision algorithms. We also review current evidence from the literature on asymmetric IOL combinations (e.g., monofocal plus multifocal, or EDOF plus trifocal), highlighting visual outcomes, patient satisfaction, and remaining evidence gaps. Overall, FOB represents a paradigm shift toward binocular, patient-customized refractive planning. Early clinical reports suggest it can deliver a continuous range of vision without significantly compromising visual quality, though careful patient counseling and case selection are essential. Future directions include the integration of advanced diagnostics, artificial intelligence-driven IOL planning tools, and adaptive optics simulations to refine this personalized approach further. The promise of FOB is to improve cataract surgery outcomes by achieving an optimal balance: one that provides each patient with excellent visual quality and functional vision across distances, tailored to their lifestyle and expectations. Full article

Background/Objectives: To assess the optical performance of two refractive premium IOLs across pupil sizes and values of corneal spherical aberration (SA). Methods: Two refractive IOLs were evaluated in this study: Tecnis Eyhance and Mini Well. The surface profiles were obtained to calculate the through-object MTF (TO MTF) curves and simulate optotype images. Entrance pupil sizes ranging from 2 to 5.5 and three corneal models were analyzed in the simulation: an average population aberrated cornea, an aberration-free cornea and a post-Lasik myopic cornea. Results: For Model 1 and pupil sizes between 3.0 and 3.5 mm, Mini Well provided acceptable visual quality from far to near distances, whereas Eyhance struggled to maintain visual quality at distances closer than intermediate. For patients with lower-than-normal corneal SA (i.e., more prolate corneas, such as post-hyperopic LASIK) both IOLs exhibited a hyperopic shift in far focus. Conversely, for patients with higher-than-normal corneal SA (i.e., more oblate corneas, such as post-myopic LASIK), the shift occurred in the myopic direction. Despite the implementation of an optimized IOL power to circumvent any shift, the TO MTF nevertheless reflected the interaction between corneal and IOL SA. Furthermore, the Mini Well demonstrated increased tolerance to less negative SA values, while Eyhance exhibited behavior consistent with a monofocal lens for more positive SA values. Conclusions: Surgeons should consider each patient’s corneal asphericity and typical pupil diameter when selecting and calculating the power of the premium IOLs studied, particularly in patients with a history of refractive surgery. Full article

Background/Objectives: A new, purely refractive extended depth-of-focus (EDOF) intraocular lens (IOL) was designed with a continuous change in power to bridge the gap between monofocal and multifocal IOLs. This study aimed to evaluate the real-world clinical outcomes of the new EDOF IOL compared with those of the enhanced monofocal IOL. Methods: A retrospective analysis was conducted on 100 eyes from 50 patients undergoing bilateral cataract surgery with either the PureSee™ EDOF (ZEN00V) or Eyhance™ (ICB00) monofocal IOL at a single institution. Visual acuity, defocus curves, contrast sensitivity, and patient-reported outcomes were evaluated three months postoperatively. Results: The ZEN00V group demonstrated superior uncorrected intermediate (0.11 ± 0.08 vs. 0.17 ± 0.11 logMAR, p = 0.006) and near visual acuity (0.25 ± 0.08 vs. 0.31 ± 0.13 logMAR, p = 0.023) compared to the ICB00 group, with comparable distance visual acuity. Both groups exhibited comparable defocus curves and contrast sensitivity. While photic phenomena were more frequent in the ZEN00V group, spectacle dependence was significantly lower for near vision (36% vs. 80%, p = 0.002) and comparable for intermediate and far vision. Conclusions: The PureSee™ EDOF IOL demonstrated enhanced intermediate and near vision with minimal compromise to distance vision while maintaining high contrast sensitivity. It also offered significant spectacle independence and patient satisfaction, making it a promising option for presbyopia correction. Full article

Objectives: This study compared the clinical outcomes of Vivinex Impress (XY1-EM) enhanced monofocal and standard Vivinex (XY1) intraocular lenses (IOLs) in mini-monovision cataract surgery. In this retrospective study, patients underwent bilateral implantation with either XY1-EM (33 patients, 66 eyes) or XY1 (24 patients, 48 eyes) in a −1D mini-monovision configuration. Methods: Visual acuity was evaluated from 5 m to 30 cm, along with spectacle dependence, contrast sensitivity, and patient-reported outcomes. Results: The XY1-EM group demonstrated significantly better intermediate and near visual acuity at distances of 30−50 cm (p < 0.05) and reduced spectacle dependence for intermediate distances (p = 0.02). Visual function questionnaire (VFQ-25) scores were significantly higher in the XY1-EM group for general vision, role difficulty, mental health, dependency, and near activity domains (p < 0.05). No significant differences were found in glare, contrast sensitivity, or quality of vision scores. Conclusions: The XY1-EM lens in mini-monovision configuration provides enhanced intermediate and near visual acuity with reduced spectacle dependence compared to standard monofocal IOLs, offering a valuable option for patients seeking improved quality of vision with reduced spectacle use. Full article

Purpose: A novel enhanced monofocal intraocular lens (IOL) has been developed to improve functional intermediate vision, maintaining a distance vision comparable to a standard monofocal lens and avoiding the drawbacks of multifocal IOLs. The aim of this study is to perform optical bench analysis and to evaluate refractive and visual outcomes and patient satisfaction. Methods: This prospective comparative single-center study was conducted in Careggi Hospital, University of Florence (Italy). We included 100 eyes from 50 patients who underwent bilateral cataract surgery. One group received the standard monofocal Tecnis GCB00 IOL, while the other group received the novel enhanced monofocal Evolux IOL. We evaluated binocular visual and refractive outcomes at 6 months after surgery. Binocular defocus curves and contrast sensitivity (CS) were also assessed. Optical quality was also analyzed in terms of higher-order aberrations (HOAs), modulation transfer function (MTF), objective scatter index (OSI), Strehl ratio, effective lens position (ELP), and halo analysis. A Patient-Reported Spectacle Independence Questionnaire (PRSIQ) was performed to assess spectacle independence outcomes. Finally, we analyzed the optical bench of both lenses. Results: All eyes implanted with Evolux achieved excellent distance vision, comparable to that achieved with GCB00. Evolux showed better intermediate and near vision, without any loss of visual quality, contrast sensitivity, or the presence of halos and photic phenomena. The optical bench analysis confirmed the different optical properties of the two lenses and supported the behavior obtained with the clinical defocus curve. Conclusions: These preliminary results show good refractive accuracy and visual outcomes for the enhanced monofocal IOL Evolux after cataract surgery. Further studies are needed to confirm our findings in terms of the number of patients and the period of follow-up. Full article

In the mix-and-match approach and in binocular intraocular lens (IOL) systems, two different IOL models are implanted in each eye to achieve the desired binocular outcome. In the mix-and-match approach, the surgeon selects the IOL models to be combined according to the clinical situation, the patient’s needs, and personal preference. Combinations described in the literature include, among others, two bifocal IOLs, an extended-depth-of-focus (EDoF) IOL with a bifocal lens, a trifocal lens with an EDoF IOL or an enhanced monofocal IOL, and two EDoF models utilizing different optical principles. The outcomes depend on the selected combination of IOL models. Binocular IOL systems consist of a fixed combination of two lenses, developed to be complementary in binocular vision. Initial data indicate that they can achieve a depth of focus similar to that with a bilateral implantation of a trifocal IOL. However, comparative studies are needed to evaluate if the postoperative binocular outcome differs from that achieved with the conventional approach. The mix-and-match implantation and binocular IOL systems expand the options available to tailor the IOL selection to the patient’s needs. Full article

Objectives: To evaluate the clinical performance and optical quality of a non-diffractive extended-depth-of-focus (EDOF) intraocular lens (IOL), Asqelio™ EDOF (models ETLIO130C/ETPIO130C), in patients undergoing cataract surgery or refractive lensectomy. Methods: This prospective observational, case-control study included patients bilaterally implanted with either the Asqelio™ EDOF IOL (Study Group) or the spherical monofocal TECNIS^® 1-Piece ZCB00 IOL (Control Group). The postoperative outcomes—at 3 months after surgery—included visual acuities at multiple distances, refraction, contrast sensitivity, the optical scatter index (OSI), wavefront aberrations, and patient-reported outcomes (Catquest-9SF and a quality-of-vision questionnaire). Results: Twenty-three patients (46 eyes) in the Asqelio™ EDOF group and 17 patients (34 eyes) in the monofocal control group were enrolled. Postoperatively, 91% of eyes in the EDOF group were within ±0.50 D of the intended spherical equivalent. The binocular uncorrected distance, intermediate, and near visual acuities were 0.00 ± 0.09, 0.13 ± 0.12, and 0.32 ± 0.15 logMAR, respectively. Contrast sensitivity and OSI values were similar between the study and control groups (p > 0.05). Higher-order aberrations were significantly lower in the EDOF group (p < 0.001), but values in both groups were clinically low. No adverse events were reported. Most patients expressed high satisfaction and reported few visual disturbances. Conclusions: The Asqelio™ EDOF IOL provided good refractive predictability, effective uncorrected vision across distance and intermediate ranges, and high patient satisfaction. Contrast sensitivity and optical scatter were comparable to monofocal implants. This lens can be considered a valuable option for patients seeking an extended range of functional vision with minimal side effects. Full article

This article provides an assessment of the impact of different levels of monovision upon early visual outcomes and quality of vision (QoV) following the bilateral implantation of enhanced monovision intraocular lenses (IOLs). Consecutive patients implanted bilaterally with the Rayone EMV (Rayner) were recruited. The dominant eye was targeted for emmetropia, and myopia was targeted in the nondominant eye. Patients were categorized based upon the postoperative refractive outcome in the nondominant eye as follows: Group A: −0.50 to −1.0 D (n = 40), Group B: <−1.00 = D (n = 46). Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, and QoV were compared 3 months postoperatively. Binocular UIVA was 0.05 ± 0.10 and −0.01 ± 0.11logMAR (p = 0.03) in the two respective groups, and binocular UNVA was 0.23 ± 0.09 and 0.14 ± 0.09logMAR (p < 0.001). Day QoV was 8.77 ± 1.33 and 8.13 ± 1.34 for night QoV in group A, and 8.85 ± 0.99 and 7.85 ± 1.35, respectively, in group B. Group A had a lower spectacle independence rate of 55% compared to 89.1%. This IOL provides a satisfactory range of vision with high QoV satisfaction. A postoperative refractive error of −1.0 D or more in the nondominant eye significantly improves binocular UIVA, UNVA, and spectacle independence, without negatively impacting QoV. Full article

Background: The aim of this study was to evaluate visual outcomes and patient satisfaction after bilateral implantation of a new hydrophobic acrylic intraocular lens called Clareon (Alcon) using the mini-monovision technique. Methods: A single-center, prospective, nonrandomized study was conducted in Tandil (Buenos Aires, Argentina), including patients scheduled for cataract surgery. To achieve mini-monovision, the spherical equivalent was calculated between −0.25 and +0.25 D for the dominant eye, and between −0.75 and −1.00 D for the non-dominant eye. The main outcomes were uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual acuity (UIVA) evaluated at 66 cm. A secondary outcome, patient satisfaction, was assessed using the CatQuest-9SF questionnaire. Results: The mean binocular UDVA was 0.01 ± 0.05 logMAR three months after surgery, while the mean binocular UIVA was 0.20 ± 0.06 logMAR. The postoperative mean spherical equivalent in the dominant eye was −0.27 ± 0.12, and in the non-dominant eye was −0.87 ± 0.25. Before surgery, the CatQuest-9SF questionnaire revealed that 83.33% of patients were dissatisfied with their vision during daily activities. Over 50% reported significant difficulties with reading newspapers, sewing, and reading TV subtitles. Additionally, 66.6% struggled with recognizing faces, 50% with seeing product prices, and 50% with walking on uneven ground. Post-surgery, most patients experienced improved vision for daily tasks, with no reports of high dissatisfaction or significant difficulties. Patients were quite satisfied with their vision for hobbies and TV subtitles, and very satisfied (90%) with seeing supermarket prices. Conclusions: patients implanted with a new enhanced monofocal IOL using the mini-monovision technique showed improved distance and intermediate visual acuity, reduced need for glasses, and expressed a high degree of satisfaction. Full article

Objectives: This study compared the visual outcomes and optical quality of two monofocal, aspheric intraocular lenses (IOLs; CT LUCIA 621P, Carl Zeiss Meditec; Eyhance ICB00, Johnson & Johnson Vision) by evaluating visual acuity, contrast sensitivity, and higher-order aberrations 1 month post-cataract surgery. Methods: In this retrospective, comparative study, 120 eyes (72 patients) that underwent cataract surgery with either CT LUCIA 621P (Lucia group) or Eyhance ICB00 (Eyhance group) implantation (60 eyes/group) were retrospectively investigated. Visual acuity at various distances and defocus curves were measured 1 month postoperatively. Optical quality was assessed by comparing contrast sensitivity and internal coma, spherical, and total aberrations by using iTrace (Tracey Technology), a ray-tracing-type aberrometer. Results: The visual acuity and defocus curves were similar between the two IOLs 1 month postoperatively. The Lucia group showed better contrast sensitivity at higher spatial frequencies: 12 cpd (p < 0.001, 1.32 LogCS vs. 1.02 LogCS) and 18 cpd (p = 0.009, 0.74 LogCS vs. 0.47 LogCS) unilaterally and 18 cpd (p = 0.044, 0.94 LogCS vs. 0.60 LogCS) bilaterally. Postoperative internal spherical aberration was significantly lower in the Lucia group (p < 0.001, −0.04 µm vs. −0.003 µm). Internal coma and total aberrations were similar. Conclusions: The visual acuity and defocus curves of the Lucia and Eyhance groups were comparable 1 month post-cataract surgery. The Lucia group’s superior contrast sensitivity and lower postoperative internal spherical aberration were due to differences in IOL designs, particularly the power variation patterns. Full article

Background: This study aims to evaluate the visual performance, both quantitative and qualitative, of the novel non-diffractive extended monofocal intraocular lens (Evolux, Sifi) following cataract surgery. This serves as a preliminary study to assess its feasibility and improve the research methodology. Methods: We conducted a single-arm, non-randomized, retrospective study at Onioptic Hospital, Craiova, Romania, involving patients who underwent cataract surgery from November 2022 to August 2023. The following visual parameters were evaluated 3 months postoperatively: monocular uncorrected (UDVA) and corrected (CDVA) distance visual acuity at 4 m; uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity at 60 cm; uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity at 40cm; postoperative refraction expressed as spheric equivalent (SE) and Quality of Vision (QoV) questionnaire scores. The contrast sensitivity and defocus curve were evaluated 1 month postoperation in 22 patients who underwent surgery in both eyes. SPSS Statistics 26.0 was used for statistical analysis, employing percentages, standard deviations (SDs), and a 95% confidence interval (95% CI). Results: Among the 103 eyes from 81 patients (mean age of 68.7 ± 1.845), 64% achieved an UDVA of logMAR 0.1 or better, and 91.26% achieved a CDVA of logMAR 0.1 or better at 3 months. Additionally, 83.24% of the eyes exhibited a UIVA of logMAR 0.3 or better, and 60.19% attained an UNVA of logMAR 0.3 or better. The SE was within ±0.50 D in 77.76% of the eyes. The QoV mean scores were as follows: frequency = 30.20 ± 16; severity = 17.19 ± 12.45; bothersome = 15.45 ± 12.94. Conclusions: The Evolux IOL demonstrated very good biometric predictability and excellent distance visual performance and very good intermediate vision, with no photopic side effects or glare in our sample population. This study provides a strong foundation for a larger comparative study with an extended depth-of-focus (EDOF) IOL, incorporating contrast sensitivity and defocus curve assessments to enhance the research quality. Full article