Visual and participant-reported outcomes of a wavefront-shaping EDOF intraocular lens implanted bilaterally with monovision

Purpose:To report visual and participant-reported outcomes after bilateral implantation of nondiffractive extended depth-of-focus (EDOF) intraocular lens (IOL) (AcrySof IQ Vivity) with monovision correction during cataract or refractive lens exchange (RLE) surgery.Setting:Europe, Australia, and New Zealand.Design:Subgroup analysis of Vivity registry.Methods:Binocular uncorrected and corrected visual acuities at distance (UDVA/CDVA), intermediate (UIVA/DCIVA), and near (UNVA/DCNVA) were assessed at 3 to 6 months after implantation. Participant-reported outcomes (satisfaction, spectacle independence, and visual disturbances) were evaluated. Data were reported by surgery type and monovision level at low (>-0.75 diopter [D] and ≤-0.50 D), medium (>-1.00 D and ≤-0.75 D), and high (≤-1.00 D).Results:Overall, 200 (of 885) participants met the monovision criteria (cataract, n = 170; RLE, n = 24). Excellent binocular UDVA and UIVA and excellent/good UNVA (mean ± SD logMAR) were noted for cataract (0.031 ± 0.102; 0.081 ± 0.114; 0.217 ± 0.144) and RLE (0.006 ± 0.093; -0.003 ± 0.089; 0.123 ± 0.097) groups, respectively. Most participants were spectacle-independent for distance and intermediate vision and very/fairly satisfied with sight; >87% from each surgery group reported no visual disturbances. Excellent UDVA was preserved at low and medium monovision. Better UNVA was observed for medium and high vs low monovision levels, whereas spectacle independence for distance and intermediate was higher for medium vs low/high monovision. High participant satisfaction and minimal visual disturbances were reported regardless of monovision level.Conclusions:Monovision correction with the nondiffractive EDOF IOL demonstrated excellent-to-good VA at all distances, high levels of spectacle independence and participant satisfaction, and minimal visual disturbances after cataract and RLE surgeries. Overall, medium monovision level performed most favorably, achieving good near VA while preserving excellent distance and intermediate vision.