Refining mini-monovision with monofocal plus intraocular lenses

PURPOSE: To evaluate simulated mini-monovision with two enhanced monofocal intraocular lenses (IOLs). METHODS: Using an optical bench, modulation and phase transfer functions of the Acunex Quantum (Teleon Surgical) and RayOne EMV (Rayner) IOLs with nominal powers of 10D, 20D, and 30D were measured. Simulated visual acuity (simVA) defocus curves were derived. Mini-monovision with an offset of -0.25D to -1.0D was simulated by shifting the simulated defocus curves and by applying quadratic summation to the acquired United States Air Force (USAF) chart images. RESULTS: The Acunex Quantum produced a more extended depth of focus than RayOne EMV in simulated defocus curves and USAF chart analysis. Higher-powered lenses tended to provide a slightly greater depth of focus. In a simulated mini-monovision, the − 1.0D myopic offset provided the greatest depth of focus, with a simVA of 0.1 logMAR and better up to approximately − 2.0D to −2.4D with Acunex Quantum and − 1.8D to −2.1D with RayOne EMV. Higher offsets with lower IOL powers resulted in a slightly worse simulated binocular distance vision in the image analysis, more noticeable with the Acunex Quantum, and a slight reduction of binocular simVA between the refractive targets in both IOLs. CONCLUSIONS: Our findings suggest that a mini-monovision approach can be successfully applied with either lens: the Acunex Quantum potentially providing a greater depth of focus, and the RayOne EMV a slightly better low-defocus tolerance for lower IOL powers in a non-dominant eye. The differences between the lenses diminished with increasing IOL power.