Comparison of visual performance between three enhanced monofocal intraocular lenses under different refractive...

To compare the monocular uncorrected visual acuity (UCVA) and contrast sensitivity (CS) of three enhanced monofocal intraocular lenses (IOLs) under emmetropic and mild myopic refractive targets.

Single-center retrospective observational study.

Among 198 patients (244 eyes) who underwent uneventful cataract surgery with enhanced monofocal IOL implantation (Tecnis Eyhance [DIB00V, E group], Vivinex Impress [XY1-EM, I group], NIDEK NSP-3 [N group]) with emmetropia or mild myopia (-1.00D), refractive targets, monocular UCVA at six different distances (5, 1, 70, 50, 40, and 30 cm) and CS with and without glare were assessed 1 month postoperatively and compared using the Kruskal-Wallis test followed by the Steel-Dwass post-hoc test.

In the emmetropic group, UCVA for all IOLs achieved ≤ 0.2 logMAR from 5 m to 50 cm, with significantly better UCVA at 5 m in the E than I group (p = 0.0300) and at 50 cm in the I than N group (p = 0.0242). For mild myopia, the N group achieved better UCVA at 5 m (p = 0.0066), the I group showed superior near-visual acuity at 30 cm than the E group (p = 0.0457), and UCVA for all IOLs achieved ≤ 0.2 logMAR from 1 m to 40 cm, with the highest CS at 6, 12, and 18 cycles per degree, with and without glare, in the E group. These findings suggest that combining enhanced monofocal IOLs with mild myopic targeting (-1.0 D) may optimize functional vision for everyday activities, particularly in older adults who rely on safe intermediate and near vision in daily life.

All IOLs showed good UCVA. The E, I, and N groups demonstrated balanced visual performance, with superior contrast sensitivity, superior near-to-intermediate vision, and superior distance vision, respectively.