Enhanced Monovision Intraocular Lenses: Current Status and Future Perspectives-Systematic Review

Background/Objectives: Cataract is the most common cause of blindness in the world. Enhanced monovision intraocular lenses (EMV IOLs) have been recently made available on the market. In this study, we aimed to further the understanding of EMV IOLs and their potential benefits in cataract surgery, while also identifying areas for future research. Methods: In this review, we discuss the findings of a few previously published comparative studies concerning different types of EMV IOLs. We conducted a systematic review of comparative studies (randomized controlled trials, prospective and retrospective observational studies) describing binocular uncorrected intermediate vision acuity (UIVA) in patients after cataract surgery and implantation of monofocal plus IOLs based on emmetropia and monovision. Results: The secondary outcomes measured were uncorrected distance visual acuity, uncorrected near visual acuity (UNVA; described in eight studies), spectacle independence and patients' satisfaction. A total of 199 patients (average age 68.11 years) were analyzed in the included studies; of these patients, 169 achieved UNVA reaching an average of 0.188 logMAR. Conclusions: The monovision approach may provide enhanced intermediate and near vision without significantly compromising distance vision or patient satisfaction, though results varied across studies. Future randomized trials with standardized outcome measures and conducted over a longer follow-up period are warranted to confirm these findings.