Two novel extended depth-of-focus intraocular lenses targeted for mini-monovision: a prospective randomized controlled trial

Purpose: To compare the visual outcomes of two extended depth-of-focus (EDOF) intraocular lenses (IOLs). Design: Single-center prospective randomized controlled trial. Methods: Patients undergoing bilateral cataract surgery were randomly assigned to receive either the Acunex Vario IOL (Teleon Surgical B.V., Spankeren, The Netherlands) or the AcrySof IQ Vivity IOL (Alcon Laboratories Inc., Fort Worth, United States of America); both Vario-group and Vivity-group were targeted for mini-monovision. The primary outcome was the uncorrected intermediate visual acuity (UIVA, measured at 66cm). Secondary outcome parameters were uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), defocus curves, reading speed, contrast sensitivity, spectacle independence and quality of vision. Setting: University Eye Clinic, Maastricht University Medical Center+, the Netherlands. Results: A total of 31 subjects (62 eyes) were included, 16 patients were enrolled into the Vario-group and 15 patients into the Vivity-group. At three months postoperatively, no statistically significant differences were found for the binocular visual acuities between the groups after adjustment for covariates. The mean and standard deviation for the binocular UIVA was 0.04±0.11 and 0.15±0.11 logMAR (adjusted-P=0.264) for the Vario-group and Vivity-group, respectively. The binocular UDVA was 0.00±0.14 and 0.08±0.10 logMAR (adjusted-P=0.753), and UNVA was 0.22±0.17 and 0.31±0.14 logMAR (adjusted-P=0.235), for both groups, respectively. While the Vario-group had a larger range of defocus, no significant differences were found for patient satisfaction and spectacle independence. Contrast sensitivity and reading speed were comparable, and there were no statistically significant differences in optical side effects between the groups. Conclusion: Bilateral implantation of the Acunex Vario IOL and the AcrySof IQ Vivity IOL targeted for mini-monovision had comparable results for binocular visual acuity outcomes, contrast sensitivity, optical side effects, and reading speed. The Vario-group showed a larger continuous range of defocus.