Visual and subject-reported outcomes of a wavefront shaping extended depth of focus intraocular lens implanted bilaterally with monovision

Purpose: To report visual and subject-reported outcomes after bilateral implantation of non-diffractive 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 (UCDVA/CDVA), intermediate (UCIVA/DCIVA), and near (UCNVA/DCNVA) were assessed at 3-6 months after implantation. Subject-reported outcomes (satisfaction, spectacle independence, visual disturbances) were evaluated. Data were reported by surgery type and monovision level at low (>-0.75D and ≤-0.50D), medium (>-1.00D and ≤-0.75D), and high (≤-1.00D). Results: Overall, 200 (of 885) subjects met the monovision criteria (cataract, n=170; RLE, n=24). Excellent binocular UCDVA and UCIVA and excellent/good UCNVA (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 subjects were spectacle-independent for distance and intermediate vision and very/fairly satisfied with sight; >87% from each surgery group reported no visual disturbances. Excellent UCDVA was preserved at low and medium monovision. Better UCNVA 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 subject satisfaction and minimal visual disturbances were reported regardless of monovision level. Conclusions: Monovision correction with the non-diffractive EDoF IOL demonstrated excellent-to-good VA at all distances, high levels of spectacle independence and subject 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.