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

PURPOSE: 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.