Visual performance after bilateral implantation of an extended depth of focus intraocular lens, AE2UV/ZOE, targeted for mini-monovision

Objective: To evaluate the impact of mini-monovision on visual performance after bilateral implantation of AE2UV/ZOE™ extended depth of focus IOLs.

Methods: This is a single-center prospective study including 60 patients who underwent bilateral cataract surgery. Patients were divided into 2 groups: with mini-monovision targeted for group 1 and emmetropia targeted for group 2. Distance, intermediate and near vision, spectacle independence and patient satisfaction were assessed 1 month after surgery.

Results: The mini-monovision group included 29 patients and the emmetropia group 31 patients. Mean uncorrected intermediate (0.08 vs. 0.19 logMAR, P=0.043) and near (0.29 vs. 0.53, P<0.001) visual acuity in the mini-monovision group were significantly better. Binocular distance visual acuity was less than 0.0 logMAR for both groups, without statistically significant difference. The level of spectacle dependence is statistically higher in the emmetropia group for intermediate and near distance activities (43% vs. 21%; 93% vs. 43% respectively; P<0.05). Patient satisfaction scores for uncorrected near vision were better in the mini-monovision group (6.25 vs. 3.17; P<0.001).

Conclusions: The mini-monovision approach in bilateral A2E/ZOE™ IOL implantation enables better visual performance in intermediate and near vision, without degradation of distance vision, with high levels of patient satisfaction.