Clinical Performance of an Enhanced Monofocal IOL Bilaterally Implanted in Patients Targeted for Monovision: A Prospective Study

<b>Background/Objectives</b>: The purpose of the study is to assess visual and refractive outcomes and patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) in a monovision configuration. <b>Methods</b>: Prospective, monocentric, non-comparative study including adults 21 years or older, with astigmatism less than 1.50 D, who were suitable for bilateral cataract surgery targeted with -1.00 D monovision. Participants were implanted with the RayOne EMV and followed up for three months. Outcome measures included refraction, monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected and distance-corrected intermediate visual acuity (UIVA and DCIVA) at 66 cm and 80 cm, binocular defocus curve, and CatQuest-9SF questionnaire. <b>Results</b>: Sixty eyes of thirty patients were included. Postoperative spherical equivalent (SEQ) was -0.16 ± 0.29 D in the dominant eyes and -1.24 ± 0.43 D in the non-dominant eyes. Binocularly, mean UDVA at 4 m was -0.01 ± 0.07 and 0.1 logMAR or better in all patients. Mean binocular UIVA at 66 cm was 0.08 ± 0.08 and 0.2 logMAR or better in 92.9% of patients. Binocular UDVA was statistically significantly improved compared to monocular UDVA of the dominant eye targeted for distance (<i>p</i> < 0.001). Similarly, binocular UIVA was statistically significantly improved compared to monocular UIVA of the non-dominant eye targeted for -1.00 D (<i>p</i> < 0.001). A total of 96.6% of patients were satisfied with their sight. <b>Conclusions</b>: Bilateral implantation of an enhanced monofocal IOL in a monovision configuration provided excellent binocular uncorrected vision at distance and intermediate ranges, demonstrating effective binocular summation and a high level of patient satisfaction.