{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:10:47Z","timestamp":1792275047485,"version":"4.4.0"},"reference-count":25,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Enhanced monofocal and non-diffractive extended depth-of-focus (EDoF) intraocular lenses (IOLs) aim to improve intermediate vision while maintaining contrast sensitivity. However, direct comparative evidence under both photopic and mesopic conditions remains limited. This study prospectively compared the visual performance of two enhanced monofocal IOLs (Tecnis\u00ae Eyhance\u2122 and ISOPure\u00ae) and one non-diffractive EDoF IOL (AcrySof\u00ae IQ Vivity\u2122). Methods: Sixty patients undergoing bilateral cataract surgery were implanted with one of three IOL groups (n = 20 each). Patients were assigned to one of three IOL groups based on preoperative consultation and clinical indications. One month postoperatively, monocular corrected distance (CDVA), distance-corrected intermediate (DCIVA), and near visual acuity (DCNVA) were measured under photopic and mesopic conditions. Photopic defocus curves, contrast sensitivity under photopic and mesopic conditions and correlation between pupil diameter and visual acuities were also assessed. Results: Baseline characteristics were comparable among groups. Under photopic conditions, Vivity\u2122 achieved significantly better UDVA, DCIVA and DCNVA than both Eyhance\u2122 and ISOPure\u00ae. Under mesopic conditions, distance acuity did not differ significantly, but Vivity\u2122 showed superior DCIVA and DCNVA. Defocus curves demonstrated a broader functional range of vision with Vivity\u2122, while Eyhance\u2122 and ISOPure\u00ae showed nearly overlapping profiles. Contrast sensitivity was similar among all IOLs under both lighting conditions, with no statistically significant differences. Conclusions: The non-diffractive EDoF AcrySof\u00ae IQ Vivity\u2122 provided a wider and more functional depth-of-focus than the enhanced monofocal lenses evaluated, without compromising contrast sensitivity. Eyhance\u2122 and ISOPure\u00ae offered comparable performance, with good distance vision and modest depth-of-focus extension. All three IOLs maintained CS levels comparable to those typically reported for standard monofocal IOLs under both photopic and mesopic illumination, indicating no clinically relevant contrast penalty.<\/jats:p>","DOI":"10.3390\/jcm15041368","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T14:05:15Z","timestamp":1770645915000},"page":"1368","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparative Photopic and Mesopic Visual Performance of Enhanced Monofocal Versus Non-Diffractive Extended Depth-of-Focus Intraocular Lenses"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2542-5131","authenticated-orcid":false,"given":"Inas","family":"Baoud Ould Haddi","sequence":"first","affiliation":[{"name":"Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanesa","family":"Bl\u00e1zquez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayan","family":"Flores-Cervantes","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Sanitas La Moraleja Hospital, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Dorronzoro-Ramirez","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Sanitas La Moraleja Hospital, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6162-0081","authenticated-orcid":false,"given":"Nuria","family":"Garz\u00f3n","sequence":"additional","affiliation":[{"name":"Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4735-2535","authenticated-orcid":false,"given":"Cristina","family":"Bonnin-Arias","sequence":"additional","affiliation":[{"name":"Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.2147\/OPTH.S318203","article-title":"Spectacle Independence and Quality of Vision After Bilateral Implantation of a Trifocal Intraocular Lens","volume":"15","author":"Shatz","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1080\/08164622.2021.1896337","article-title":"Visual function and mobility after multifocal versus monofocal intraocular lens implantation","volume":"105","author":"Hall","year":"2022","journal-title":"Clin. Exp. Optom."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Liu, J., Dong, Y., and Wang, Y. (2019). Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: A systematic review and meta-analysis. BMC Ophthalmol., 19.","DOI":"10.1186\/s12886-019-1204-0"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Palomino-Bautista, C., Cervi\u00f1o, A., Cui\u00f1a-Sardi\u00f1a, R., Carmona-Gonzalez, D., Castillo-Gomez, A., and Sanchez-Jean, R. (2022). Depth of field and visual performance after implantation of a new hydrophobic trifocal intraocular lens. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02462-3"},{"key":"ref_5","first-page":"241","article-title":"Predictive factors for photic phenomena after refractive, rotationally asymmetric, multifocal intraocular lens implantation","volume":"10","author":"Tchah","year":"2017","journal-title":"Int. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1097\/APO.0000000000000439","article-title":"Comparison Between an Intraocular Lens With Extended Depth of Focus (Tecnis Symfony ZXR00) and a New Monofocal Intraocular Lens With Enhanced Intermediate Vision (Tecnis Eyhance ICB00)","volume":"10","author":"Jeon","year":"2021","journal-title":"Asia Pac. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/APO.0000000000000590","article-title":"Latest Development in Extended Depth-of-Focus Intraocular Lenses: An Update","volume":"12","year":"2023","journal-title":"Asia Pac. J. Ophthalmol."},{"key":"ref_8","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_9","doi-asserted-by":"crossref","unstructured":"Mencucci, R., Romualdi, G., Carnicci, A., Panini, F., Buzzi, M., and Giansanti, F. (2025). Long-Term Effectiveness of a Monofocal Intraocular Lens (IOL) Enhanced for Intermediate Vision: A 5-Year Follow-Up Study. J. Clin. Med., 14.","DOI":"10.3390\/jcm14165831"},{"key":"ref_10","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_11","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1111\/opo.13287","article-title":"Optical and aberrometric evaluation of a new enhanced monofocal intraocular lens with isofocal optic design","volume":"44","author":"Charbel","year":"2024","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s40135-022-00283-7","article-title":"The Vivity IOL: The European Experience","volume":"10","author":"Cummings","year":"2022","journal-title":"Curr. Ophthalmol. Rep."},{"key":"ref_13","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_14","doi-asserted-by":"crossref","first-page":"4119698","DOI":"10.1155\/2022\/4119698","article-title":"Clinical and Aberrometric Evaluation of a New Monofocal IOL with Intermediate Vision Improvement","volume":"2022","author":"Bova","year":"2022","journal-title":"J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40662-024-00424-y","article-title":"Influence of preoperative variables on the 3-month functional outcomes of the Vivity extended depth-of-focus intraocular lens: A prospective case series","volume":"12","author":"Savini","year":"2025","journal-title":"Eye Vis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1177\/11206721221125004","article-title":"Visual outcomes of non-diffractive extended-depth-of-focus and enhanced monofocal intraocular lenses: A case-control study","volume":"33","author":"Sabur","year":"2023","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1177\/11206721231154818","article-title":"A comparative evaluation of three extended depth of focus intraocular lenses","volume":"33","author":"Lesieur","year":"2023","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_18","first-page":"25158414231200108","article-title":"Evaluation of extended depth-of-focus hydrophobic intraocular lens with an optic concept based on combination of high-order aberrations","volume":"15","author":"Stodulka","year":"2023","journal-title":"Ther. Adv. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41433-024-03039-8","article-title":"Quality of vision clinical outcomes for a new fully-refractive extended depth of focus Intraocular Lens","volume":"38","author":"Corbett","year":"2024","journal-title":"Eye"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"598","DOI":"10.18240\/ijo.2025.04.05","article-title":"Comparison of visual acuity and optical quality between higher-order aspheric monofocal and standard introcular lenses","volume":"18","author":"Janekova","year":"2025","journal-title":"Int. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1007\/s00417-023-06322-8","article-title":"Optical characterization and through-focus performance of two advanced monofocal intraocular lenses","volume":"262","author":"Borges","year":"2024","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/j.jcrs.0000000000000826","article-title":"Nondiffractive wavefront-shaping extended depth-of-focus intraocular lens: Visual performance and patient-reported outcomes","volume":"48","author":"Kohnen","year":"2022","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/j.jcrs.0000000000001142","article-title":"Comparison of visual performance and quality of life with a new nondiffractive EDOF intraocular lens and a trifocal intraocular lens","volume":"49","author":"Asena","year":"2023","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_24","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_25","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3928\/1081597X-20200212-01","article-title":"Extended Depth of Focus Versus Monofocal IOLs: Objective and Subjective Visual Outcomes","volume":"36","author":"Pedrotti","year":"2020","journal-title":"J. Refract. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/4\/1368\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T11:42:45Z","timestamp":1770810165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/4\/1368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15041368"],"URL":"https:\/\/doi.org\/10.3390\/jcm15041368","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}