Intermediate Vision Following Monofocal IOL Implantation

While providing exceptional distance visual outcomes, intermediate vision achieved with monofocal IOLs has not been thoroughly investigated.

A total of 63 eyes from 52 patients (average age 73.48±6.8 years, 56% female) were included for analysis following implantation of the Clareon and Clareon Toric monofocal intraocular IOL with AutonoMe (CNA0T0 or CNA0T2-T6) for the treatment of cataract or refractive error. Visual and refractive outcomes including uncorrected distance, intermediate and near visual acuity, distance-corrected intermediate and near visual acuity, manifest refraction and defocus were first assessed at 4-6 weeks and then again at 12 weeks following surgery. Patient satisfaction was assessed using a modification of the IOLSAT questionnaire and subjective visual quality was assessed using a modified version of the QUVID questionnaire.

Average postoperative spherical equivalent (SE) was -0.17±0.40 D, with 82% and 96% of eyes achieving within ±0.5 D and ±1.0 D of the refractive SE target, respectively. Average monocular uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual acuity (UIVA) were 0.03±0.10 and 0.35±0.13 LogMAR. Postoperative UIVA improved with more myopic SE (P < 0.0001) and spherical refractive error (P < 0.0001). Bilaterally implanted patients had higher spectacle independence for intermediate tasks compared to unilateral patients (51.1% versus 31.2% respectively).

The Clareon monofocal IOL provided excellent distance vision with a majority of patients achieving spectacle independence for intermediate tasks. While the IOL likely contributed to these visual outcomes, surgeons can also adjust refractive targets to help achieve better intermediate vision postoperatively.