Optical performance of enhanced monofocal intraocular lens in presence of low degree of corneal astigmatism

Purpose: To evaluate the optical performance of an enhanced monofocal intraocular lens (IOL) in the presence of cataract and a low degree of corneal astigmatism. Methods: A prospective, comparative, nonrandomized study was conducted to compare the results of an enhanced monofocal IOL with a standard monofocal IOL in cases of cataract with corneal astigmatism ≥0.75 D and <1.5 D. A total of 38 patients meeting the inclusion criteria were enrolled in the study. Group A patients (19) were implanted with enhanced monofocal IOLs bilaterally, and Group B patients (19) received standard monofocal IOLs bilaterally. Both groups underwent standard procedures (phacoemulsification with IOL implantation in the capsular bag), and final outcomes were analyzed after a 3-month follow up. A P value < 0.05 was considered significant. Results: The binocular uncorrected intermediate visual acuity, near visual acuity, and contrast sensitivity at 3 months was better in the enhanced monofocal group compared to the standard monofocal group ( P < 0.001, P < 0.001, P = 0.02 respectively). The binocular uncorrected distance visual acuity at 3 months was comparable between the groups ( P = 0.2); however, a higher number of cases attained visual acuity better than 6/9 in the enhanced monofocal IOL group. Post-operative higher-order aberrations were comparable between the groups. ( P = 0.125). Conclusion: Bilateral implantation of enhanced monofocal IOLs in patients with cataract and low degrees of corneal astigmatism demonstrates better tolerance to astigmatism compared to standard monofocal IOLs. In cases with <1 D corneal astigmatism, the enhanced monofocal IOL is the preferred choice over the standard monofocal IOL.