Comparing visual acuity, range of vision and spectacle independence in the extended range of vision and monofocal intraocular lens

IMPORTANCE This study is the first to compare the extended range of vision (ERV) intraocular lens (IOL) targeted at micro-monovision to a monofocal targeted at binocular emmetropia. BACKGROUND Compares visual acuity, range of vision and spectacle independence in monofocal and ERV IOLs. DESIGN Assessor-blinded retrospective cohort study. PARTICIPANTS Eighty-eight participants (176 eyes) with bilateral IOL implants at 5+ month postoperative review. METHODS Regression analyses (general estimating equations and multiple linear regression) tested associations between IOL type (ZA9002 Tecnis 3-piece or Tecnis ZCT monofocal; and Tecnis Symfony ERV IOL) and visual acuity, adjusting for key confounders including residual astigmatism. MAIN OUTCOME MEASURES Monocular and binocular visual acuity measured with and without distance refractive correction at distance (3.00 m), intermediate (1.00 and 0.63 m) and near (0.40 m) (logMAR units); near vision reading test used British 'N' notation; self-reported spectacle independence. RESULTS There was no significant difference between ERV and monofocal groups in uncorrected binocular visual acuity at distance (P = 0.595). Binocular uncorrected visual acuity at intermediate (0.63 m: monofocal 0.24, ERV 0.09, P < 0.001) and near (0.40 m: monofocal 0.42, ERV 0.18, P < 0.001) were significantly better in the ERV group. Binocular uncorrected near vision: all the ERV group read N8 or better, compared to 36% in the monofocal group (P < 0.001); 93% of the ERV group reported spectacle independence at near compared to 33% in the monofocal group (P < 0.001). CONCLUSIONS AND RELEVANCE The ERV IOL, targeted to achieve micro-monovision, demonstrated superior range of visual acuity and spectacle independence compared to the monofocal targeted to achieve emmetropia.