A Prospective, Randomized Comparison of Three Partial Range of Field Intraocular Lenses Using a Mini-monovision Strategy

Purpose: To evaluate the visual and refractive outcomes of three different partial range of field intraocular lenses (PRoF IOLs) using a mini-monvision strategy. Methods: This was a single-center, prospective, randomized double-blind study enrolling 105 patients who underwent bilateral cataract surgery with implantation of either Isopure (BVI Medical, n = 36), Tecnis Eyhance (Johnson & Johnson, n = 35), or AcrySof IQ Vivity (Alcon Laboratories, Inc, n = 34) IOLs. Binocular and monocular (dominant eye) visual acuity at distance, intermediate, and near ranges, defocus curves, and spectacle independence (PRSIQ) were assessed over a 6-month follow-up. Mini-monovision (−0.50 diopters [D] in the non-dominant eye) was employed. Results: At 6 months, binocular uncorrected distance visual acuity was excellent (Isopure: −0.06 ± 0.09; Vivity: −0.01 ± 0.09; Eyhance: −0.05 ± 0.07 logarithm of the minimum angle of resolution [logMAR]; P = .077). Binocular uncorrected intermediate visual acuity was similar across the three groups (Isopure: 0.07 ± 0.10; Vivity: 0.05 ± 0.08; Eyhance: 0.06 ± 0.11 logMAR; P = .592). Vivity showed better binocular uncorrected near visual acuity than Isopure and Eyhance (Isopure: 0.29 ± 0.13; Vivity: 0.19 ± 0.12; Eyhance: 0.30 ± 0.15 logMAR; P ≤ .012). Monocular uncorrected and corrected distance visual acuity were significantly worse in the Vivity group ( P < .001 vs Vivity). All IOLs maintained binocular visual acuity ≤0.20 logMAR from +1.00 to −1.50 diopters (D), with Vivity showing superior performance at −1.50 and −2.00 D. Spectacle independence was high for distance (≥85%) and intermediate (≥92%) tasks in all groups. Most patients required near correction at least occasionally. Conclusions: All three PRoF IOLs provided excellent distance and intermediate vision with functional near vision using a mini-monvision strategy. Vivity offered slightly better near acuity and defocus performance, whereas Isopure and Eyhance tended to show superior distance vision.