Visual outcomes, satisfaction, and spectacle independence with a nondiffractive extended vision intraocular lens targeted for slight monovision

Abstract

Purpose: To evaluate vision, satisfaction, and spectacle independence of the AcrySof IQ Vivity intraocular lens when the nondominant eye is targeted for slight myopia. Setting: 1 clinical practice in the United States. Design: Prospective unmasked nonrandomized clinical trial. Methods: Patients presenting for cataract surgery interested in reducing their dependence on spectacles were enrolled, with the dominant eye targeted for emmetropia and the nondominant eye targeted for slight monovision (−0.50 diopters [D]). Visual disturbances, satisfaction, and spectacle independence were evaluated. Visual acuity (VA) was tested at distance (4 m), intermediate (66 cm), and near (40 cm) at 3 months postoperatively when uncorrected, with both eyes corrected to emmetropia and with 1 eye adjusted for monovision. 2 binocular defocus curves were also collected under the latter 2 conditions. Results: Data from 31 patients were analyzed. The mean refractive spherical equivalent was 0.45 D more myopic in the nondominant eye, resulting in worse uncorrected VA at distance but better uncorrected VA at near. The binocular defocus curve with monovision showed significantly better VA from −2.0 to −3.0 D, and patients reported less need for spectacles (and better vision) at near than reported with binocular emmetropia. Glare, blurred vision, and starbursts were the most reported visual disturbances. Although not correlated with the difference in refraction, glare and blurred vision were significantly correlated with overall satisfaction. Conclusions: Implanting this IOL with a target of slight myopia in the nondominant eye appears to be a viable way to improve near vision, although with an increased potential for visual disturbances.