Vision and patient-reported outcomes with nondiffractive EDOF or neutral aspheric monofocal intraocular lenses

To compare outcomes in patients who underwent cataract extraction with implantation of nondiffractive extended depth-of-focus (ND-EDOF; Alcon AcrySof Vivity) or neutral aspheric monofocal (Bausch & Lomb enVista) intraocular lenses (IOLs).Setting:Academic medical center.Design:Prospective single-center double-arm patient- and assessor-masked randomized controlled trial.Methods:Patients were randomized to receive either a ND-EDOF or monofocal IOL in both eyes, targeted for emmetropia. Uncorrected and corrected (CDVA) distance visual acuities, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), level of spectacle independence, and severity of photic phenomena were assessed at 3 months postoperatively.Results:56 patients were enrolled, of which 24 in the ND-EDOF group and 27 in the monofocal group completed follow-up. The binocular mean CDVA, DCIVA, and DCNVA were 20/20, 20/19, and 20/21 for the ND-EDOF IOL and 20/18 (P =.188), 20/31 (P <.001), and 20/30 (P =.004) for the monofocal IOL, respectively. At intermediate, 88% of the ND-EDOF vs 30% of the monofocal patients had a binocular DCIVA of 20/25 or better (P <.001). Moderate or severe glare occurred in 20.8% of ND-EDOF vs 7.4% of monofocal patients (P =.228), whereas moderate or severe halos occurred in 16.7% of ND-EDOF vs 11.1% of monofocal patients (P =.697).Conclusions:The ND-EDOF and monofocal IOLs provided similarly excellent distance vision. Patients implanted with the ND-EDOF IOL had 2 more lines of vision at both intermediate and near, and a greater proportion reported spectacle independence. Most patients in both groups reported low severity of photic phenomena.