Postoperative Visual Function of Enhanced Monofocal Intraocular Versus Monofocal Lenses

To compare the postoperative visual performance of the Vivinex Impress (Hoya Surgical Optics) with that of a monofocal intraocular lens (IOL) on the same platform.

This retrospective observational study analyzed consecutive patients who underwent cataract surgery between February and October 2024. Patients with postoperative emmetropia as the target refraction, preoperative corneal astigmatism less than 1.00 diopter (D), no history of refractive surgery, and no other ocular diseases or amblyopia were analyzed. Fifty eyes implanted with the Vivinex Impress (Impress group) were compared with 50 eyes implanted with the Vivinex MultiSert (MultiSert group). One month postoperatively, uncorrected distance visual acuity, uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity, corrected distance visual acuity, and contrast sensitivity were evaluated. Data on patient satisfaction levels, dysphotopsia incidence, and spectacle use rates were obtained.

UIVA (logarithm of the minimum angle of resolution) was significantly better in the Impress group (0.12 ± 0.12) compared to the MultiSert group (0.18 ± 0.13) (P = .003), with no significant differences in other visual acuity measures. Multivariate analysis revealed a negative correlation between UIVA and postoperative pupil diameter in the Impress group. Predicted refractive error differed significantly (Impress group: -0.13 ± 0.43 and MultiSert group: 0.10 ± 0.46). No significant differences were observed in the contrast sensitivity, patient satisfaction levels, dysphotopsia incidence, or spectacle use rates between the groups.

The Impress group demonstrated superior intermediate visual acuity and a myopic shift from the target refraction. Preoperative pupil diameter may help identify patients most likely to benefit from the Impress lens. [J Refract Surg. 2025;41(6):e551-e557.].