Visual Performance and Patient-Reported Visual Function with Multifocal, Monofocal, and Enhanced Monofocal Intraocular Lenses

Abstract Objective To evaluate the visual performance and patient satisfaction of three intraocular lenses (IOLs): the newly-designed monofocal-plus Tecnis Eyhance, multifocal Tecnis Synergy, and monofocal Sensar (Johnson & Johnson Surgical Vision©, Inc. Santa Ana, CA, USA). Methods This prospective, comparative, interventional study enrolled patients undergoing cataract surgery with implantation of Eyhance, Sensar, or Synergy IOLs. Postoperative uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were assessed at distance (6m), intermediate (70 cm), and near (40 cm) in LogMAR units. Contrast sensitivity (CS) was measured using the Pelli-Robson chart at distance and near vision. Subjective visual comfort was evaluated through a validated questionnaire. Results The study included 52 participants (52% females; 84 eyes): 40 eyes with Eyhance, 26 with Synergy, and 18 with Sensar. Ages ranged from 48 to 82 years (mean age 70.2 ± 7.59 years), with 59% female participants. There was no significant difference in distance UCVA among the IOL types (P > 0.8). Synergy showed superior intermediate and near UCVA compared to Eyhance and Sensar (P < 0.01). Eyhance and Sensar demonstrated better distance CS than Synergy (P ≤ 0.05) and better near CS (P < 0.05). Questionnaire responses showed no significant difference in overall visual comfort, but higher satisfaction with intermediate vision was reported for Synergy. Conclusions The Synergy lens is recommended for patients prioritizing intermediate and near vision. Eyhance did not show an objective advantage over Sensar for intermediate vision and contrast sensitivity (CS) but had a subjective advantage. Despite reduced CS, Synergy provided excellent distance UCVA, similar to Eyhance and Sensar.