{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:47:59Z","timestamp":1794019679574,"version":"4.8.0"},"reference-count":45,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Ministry of Health and Welfare","award":["HI19C0481"],"award-info":[{"award-number":["HI19C0481"]}]},{"name":"the Ministry of Health and Welfare","award":["HC19C0276"],"award-info":[{"award-number":["HC19C0276"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aimed to compare the efficacies and safety of enhanced and standard monofocal intraocular lenses (IOLs) in eyes with early glaucoma. Patients with concurrent cataracts and open-angle glaucoma (OAG) were enrolled. They underwent cataract surgery with IOL implantation. The comprehensive preoperative ophthalmic examination included the manifest refraction; monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA); visual field (VF); and contrast sensitivity (CS); defocus curves and questionnaires were assessed three months postoperatively. Totals of 34 and 38 patients had enhanced and standard monofocal IOLs, respectively. The enhanced monofocal IOL provided better UIVA than the standard monofocal IOL (p = 0.003) but similar UDVA, CDVA, and UNVA. The enhanced monofocal IOL had more consistent defocus curves than the standard monofocal IOL, especially at \u22121 (p = 0.042) and \u22121.5 (p = 0.026) diopters. The enhanced monofocal IOL provided better satisfaction (p = 0.019) and lower spectacle dependence (p = 0.004) than the standard monofocal IOL for intermediate vision, with similar VF and CS outcomes. In conclusion, enhanced monofocal IOLs are recommended for patients with OAG because they provide better intermediate vision, higher satisfaction, and lower dependence on spectacles than standard monofocal IOLs, without worsening other visual outcomes.<\/jats:p>","DOI":"10.3390\/jcm12185830","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T10:09:50Z","timestamp":1694081390000},"page":"5830","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of the Visual Outcomes of Enhanced and Standard Monofocal Intraocular Lens Implantations in Eyes with Early Glaucoma"],"prefix":"10.3390","volume":"12","author":[{"given":"Jeoung Woo","family":"Nam","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haowei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7512-7303","authenticated-orcid":false,"given":"Mi Sun","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"ref_1","first-page":"844","article-title":"Global Data on Visual Impairment in the Year 2002","volume":"82","author":"Resnikoff","year":"2004","journal-title":"Bull. World Health Organ."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1001\/jama.2012.9014","article-title":"Risk of Fractures Following Cataract Surgery in Medicare Beneficiaries","volume":"308","author":"Tseng","year":"2012","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S0161-6420(02)01094-1","article-title":"Risk Factors for Incident Nuclear Opacities","volume":"109","author":"Leske","year":"2002","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.ajo.2006.06.052","article-title":"Topical Ocular Hypotensive Medication and Lens Opacification: Evidence from the Ocular Hypertension Treatment Study","volume":"142","author":"Herman","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_5","unstructured":"(2023, July 02). Cataract Surgery Outcomes in Glaucomatous Eyes: Results from the Veterans Affairs Ophthalmic Surgery Outcomes Data Project\u2014ClinicalKey. Available online: https:\/\/www.clinicalkey.com\/#!\/content\/playContent\/1-s2.0-S0002939415004444?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0002939415004444%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.ajo.com%2F."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1001\/archopht.124.12.1694","article-title":"Cataract Extraction in the Collaborative Initial Glaucoma Treatment Study: Incidence, Risk Factors, and the Effect of Cataract Progression and Extraction on Clinical and Quality-of-Life Outcomes","volume":"124","author":"Musch","year":"2006","journal-title":"Arch. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"54","DOI":"10.5005\/jp-journals-10008-1138","article-title":"Premium IOLs in Glaucoma","volume":"7","author":"Ichhpujani","year":"2013","journal-title":"J. Curr. Glaucoma Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/IJG.0000000000001379","article-title":"Contrast Sensitivity and Glaucoma","volume":"29","author":"Ichhpujani","year":"2020","journal-title":"J. Glaucoma"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.jcrs.2013.12.011","article-title":"Multifocal Intraocular Lenses: Relative Indications and Contraindications for Implantation","volume":"40","author":"Chang","year":"2014","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1016\/j.ophtha.2021.03.013","article-title":"Multifocal and Accommodating Intraocular Lenses for the Treatment of Presbyopia: A Report by the American Academy of Ophthalmology","volume":"128","author":"Schallhorn","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/ICU.0b013e3283365154","article-title":"Intraocular Lens Choices for Patients with Glaucoma","volume":"21","author":"Teichman","year":"2010","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"861","DOI":"10.2147\/OPTH.S404369","article-title":"Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma","volume":"17","author":"Ferguson","year":"2023","journal-title":"Clin. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"436","DOI":"10.3928\/1081597X-20160428-06","article-title":"Comparative Analysis of the Clinical Outcomes With a Monofocal and an Extended Range of Vision Intraocular Lens","volume":"32","author":"Pedrotti","year":"2016","journal-title":"J. Refract. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20153","DOI":"10.1038\/s41598-020-77214-8","article-title":"Influence of Implantations of Extended Depth-of-Focus on Standard Automated Perimetry","volume":"10","author":"Lee","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Takahashi, M., Yamashiro, C., Yoshimoto, T., Kobayashi, Y., Higashijima, F., Kobayashi, M., Hatano, M., Ohta, M., Nagai, T., and Teranishi, S. (2020). Influence of Extended Depth of Focus Intraocular Lenses on Visual Field Sensitivity. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0237728"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/j.jcrs.0000000000000399","article-title":"Clinical Evaluation of a New Monofocal IOL with Enhanced Intermediate Function in Patients with Cataract","volume":"47","author":"Auffarth","year":"2021","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"538","DOI":"10.3928\/1081597X-20220707-01","article-title":"Enhanced Monofocal Versus Conventional Monofocal Intraocular Lens in Cataract Surgery: A Meta-Analysis","volume":"38","author":"Wan","year":"2022","journal-title":"J. Refract. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e164","DOI":"10.1016\/j.ophtha.2020.09.026","article-title":"Multifocal and Extended Depth-of-Focus Intraocular Lenses in 2020","volume":"128","author":"Rampat","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/j.jcrs.0000000000000712","article-title":"Multicountry Clinical Outcomes of a New Nondiffractive Presbyopia-Correcting IOL","volume":"48","author":"Bala","year":"2022","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Majstruk, L., Leray, B., Bouillot, A., Mich\u00e9e, S., Sultan, G., Baudouin, C., and Labb\u00e9, A. (2019). Long Term Effect of Phacoemulsification on Intraocular Pressure in Patients with Medically Controlled Primary Open-Angle Glaucoma. BMC Ophthalmol., 19.","DOI":"10.1186\/s12886-019-1157-3"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Park, K., Kim, J., and Lee, J. (2017). Measurement of Macular Structure-Function Relationships Using Spectral Domain-Optical Coherence Tomography (SD-OCT) and Pattern Electroretinograms (PERG). PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0181390"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"913","DOI":"10.18240\/ijo.2020.06.09","article-title":"Rainbow Halos Occur Less Following Implantation of Extended Range of Vision One-Piece Intraocular Lenses vs Diffractive Bifocal Intraocular Lenses","volume":"13","author":"Kim","year":"2020","journal-title":"Int. J. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/j.preteyeres.2007.08.001","article-title":"A Framework for Comparing Structural and Functional Measures of Glaucomatous Damage","volume":"26","author":"Hood","year":"2007","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Huh, J., Eom, Y., Yang, S.K., Choi, Y., Kim, H.M., and Song, J.S. (2021). A Comparison of Clinical Outcomes and Optical Performance between Monofocal and New Monofocal with Enhanced Intermediate Function Intraocular Lenses: A Case-Control Study. BMC Ophthalmol., 21.","DOI":"10.1186\/s12886-021-02124-w"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.ajo.2015.07.021","article-title":"Clinical Outcomes Following Implantation of Diffractive Multifocal Intraocular Lenses with Varying Add Powers","volume":"160","author":"Kim","year":"2015","journal-title":"Am. J. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jcrs.2012.12.002","article-title":"Multifocal Intraocular Lenses in Cataract Surgery: Literature Review of Benefits and Side Effects","volume":"39","author":"Nuijts","year":"2013","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.2147\/OPTH.S175901","article-title":"A Clinical Assessment of Visual Performance of Combining the TECNIS\u00ae Symfony Extended Range of Vision IOL (ZXR00) with the +3.25 D TECNIS Multifocal 1-Piece IOL (ZLB00) in Subjects Undergoing Bilateral Cataract Extraction","volume":"12","author":"Black","year":"2018","journal-title":"Clin. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.jcrs.2016.01.014","article-title":"Efficacy and Safety of Multifocal Intraocular Lenses Following Cataract and Refractive Lens Exchange: Metaanalysis of Peer-Reviewed Publications","volume":"42","author":"Rosen","year":"2016","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez, J., Rocha-de-Lossada, C., Zamorano-Mart\u00edn, F., Rodr\u00edguez-Calvo-de-Mora, M., and Rodr\u00edguez-Vallejo, M. (2023). Positioning of Enhanced Monofocal Intraocular Lenses between Conventional Monofocal and Extended Depth of Focus Lenses: A Scoping Review. BMC Ophthalmol., 23.","DOI":"10.1186\/s12886-023-02844-1"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Choi, W.K., Han, H.J., Son, H.-S., Khoramnia, R., Auffarth, G.U., and Choi, C.Y. (2023). Clinical Outcomes of Bilateral Implantation of New Generation Monofocal IOL Enhanced for Intermediate Distance and Conventional Monofocal IOL in a Korean Population. BMC Ophthalmol., 23.","DOI":"10.1186\/s12886-023-02897-2"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/opo.12236","article-title":"Intermediate Addition Multifocals Provide Safe Stair Ambulation with Adequate \u201cshort-Term\u201d Reading","volume":"36","author":"Elliott","year":"2016","journal-title":"Ophthalmic Physiol. Opt. J. Br. Coll. Ophthalmic Opt. Optom."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/j.jcrs.0000000000000061","article-title":"Visual Outcome, Optical Quality, and Patient Satisfaction with a New Monofocal IOL, Enhanced for Intermediate Vision: Preliminary Results","volume":"46","author":"Mencucci","year":"2020","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s10792-020-01599-8","article-title":"Vision Outcomes with a New Monofocal IOL","volume":"41","author":"Cinar","year":"2021","journal-title":"Int. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/00061198-200304000-00008","article-title":"Comparison of Contrast Sensitivity, Visual Acuity, and Humphrey Visual Field Testing in Patients with Glaucoma","volume":"12","author":"Hawkins","year":"2003","journal-title":"J. Glaucoma"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1055\/s-2000-10582","article-title":"Synopsis of various electrophysiological tests in early glaucoma diagnosis--temporal and spatiotemporal contrast sensitivity, light- and color-contrast pattern-reversal electroretinogram, blue-yellow VEP","volume":"216","author":"Korth","year":"2000","journal-title":"Klin. Monatsbl. Augenheilkd."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/j.ophtha.2008.04.017","article-title":"One-Year Outcomes with New-Generation Multifocal Intraocular Lenses","volume":"115","author":"Cillino","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_37","first-page":"27","article-title":"Comparison of Diffractive and Refractive Multifocal Intraocular Lenses in Presbyopia Treatment","volume":"32","author":"Dekaris","year":"2008","journal-title":"Coll. Antropol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1111\/j.1442-9071.2010.02357.x","article-title":"Differences in Contrast Sensitivity between Monofocal, Multifocal and Accommodating Intraocular Lenses: Long-Term Results","volume":"38","author":"Mesci","year":"2010","journal-title":"Clin. Experiment. Ophthalmol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"520","DOI":"10.3928\/1081597X-20200612-01","article-title":"Enhancing the Intermediate Vision of Monofocal Intraocular Lenses Using a Higher Order Aspheric Optic","volume":"36","author":"Alarcon","year":"2020","journal-title":"J. Refract. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0002-9394(01)00920-5","article-title":"Influence of Cataract Surgery on Automated Perimetry in Patients with Glaucoma","volume":"132","author":"Hayashi","year":"2001","journal-title":"Am. J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s10384-016-0467-8","article-title":"Changes of Visual-Field Global Indices after Cataract Surgery in Primary Open-Angle Glaucoma Patients","volume":"60","author":"Seol","year":"2016","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1097\/IJG.0b013e31822e8e37","article-title":"Effect of Cataract Extraction on Visual Field Index in Glaucoma","volume":"22","author":"Rao","year":"2013","journal-title":"J. Glaucoma"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ajo.2014.04.017","article-title":"Reduction in Mean Deviation Values in Automated Perimetry in Eyes with Multifocal Compared to Monofocal Intraocular Lens Implants","volume":"158","author":"Farid","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1001\/jamaophthalmol.2013.2368","article-title":"Influence of Multifocal Intraocular Lenses on Standard Automated Perimetry Test Results","volume":"131","author":"Aychoua","year":"2013","journal-title":"JAMA Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/j.ajo.2006.11.059","article-title":"Relationship between Foveal Threshold and Visual Acuity Using the Humphrey Visual Field Analyzer","volume":"143","author":"Flaxel","year":"2007","journal-title":"Am. J. Ophthalmol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/18\/5830\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:46:53Z","timestamp":1760129213000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/18\/5830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,7]]},"references-count":45,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12185830"],"URL":"https:\/\/doi.org\/10.3390\/jcm12185830","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,7]]}}}