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Visual Outcomes and Reading Performance of a Non-Diffractive EDOF IOL in Chinese Eyes: A Prospective Comparison of
Chen-Cheng Chao1,2, Yu-Yi Lin3, Shao-Yu Sung1,4
1Nobel Eye Institute, Taipei, Taiwan.
Purpose:
To evaluate the visual outcomes, reading performance, and patient satisfaction following bilateral implantation of a non-diffractive extended depth-of-focus (EDOF) intraocular lens (IOL) in Chinese eyes, and to compare the efficacy of emmetropia versus mini-monovision targets.
Patients And Methods:
This prospective, multi-center, observational study included 72 patients (144 eyes) who underwent phacoemulsification with bilateral implantation of the AcrySof IQ Vivity IOL (or Toric model). Patients were divided into two groups based on the refractive target: emmetropia (n=29) and mini-monovision (n=43). At 3 months postoperatively, binocular uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities were assessed. Functional outcomes were evaluated using the International Reading Speed Test (IReST), the Questionnaire for Visual Disturbances (QUVID), and the Intraocular Lens Satisfaction (IOLSAT) questionnaire.
Results:
At 3 months, both groups achieved excellent binocular uncorrected distance visual acuity (emmetropia: 0.03 ± 0.06 logMAR; mini-monovision: 0.05 ± 0.06 logMAR) and uncorrected intermediate visual acuity (emmetropia: 0.12 ± 0.14 logMAR; mini-monovision: 0.13 ± 0.14 logMAR). No statistically significant differences were observed in binocular UIVA (p=0.317) or UNVA (p=0.684) between the emmetropia and mini-monovision groups, although the mini-monovision group demonstrated significantly higher rates of spectacle independence (89.2% vs. 70.4%, p = 0.049). The mean reading speed improved significantly from 172 ± 67 wpm preoperatively to 201 ± 58 wpm postoperatively (p<0.05). Regarding visual disturbances, 100% of patients in both groups reported "none to a little" for starbursts, halos, and glare. Patient satisfaction was high in both cohorts (66.7% in the emmetropia group and 79.5% in the mini-monovision group).
Conclusion:
The non-diffractive Vivity IOL provides excellent distance and intermediate vision with a favorable visual disturbance profile in Chinese eyes. While the mini-monovision strategy enhanced spectacle independence and patient satisfaction, the improvements in uncorrected near acuity were not statistically significant compared to emmetropia. These short-term findings suggest that a myopic target closer to -0.75 D or -1.00 D may need to be evaluated to maximize chart-based near vision benefits in this population.
