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  • Cataract/Anterior Segment, Refractive Mgmt/Intervention

    Review of: Comparative analysis of visual outcome with 3 introcular lenses: Monofocal, enhanced monofocal and extended depth of focus

    Corbelli E, Iuliano L, Bandello F, et al. Journal of Cataract and Refractive Surgery, January 2022

    Investigators in Italy used a nonrandomized prospective comparative case series to compare visual outcomes with monofocal, enhanced monofocal, and extended depth-of-focus (EDOF) intraocular lenses (IOLs).

    Study design

    Twenty-five patients scheduled for bilateral consecutive cataract surgery were included in each of 3 arms (total 150 eyes of 75 patients). The primary measures were 6-month postoperative outcomes for halo and glare scores, binocular uncorrected visual acuity, and spectacle independence score.


    Monocular and binocular visual acuity and contrast were similar for all 3 IOL groups. The enhanced monofocal IOL showed binocular intermediate vision similar to that of the EDOF IOL, while the latter showed highest binocular near vision but the worst halos and glares.


    The small number of patients enrolled was one of the study’s limitations. In addition, there was no trifocal IOL arm for comparison. Last, these data cannot be assumed to apply for other lens platforms, as optical quality may be different for those.

    Clinical significance

    There has been controversy about the use of EDOF IOLs: Should patients pay the higher price for an EDOF IOL, or would an enhanced monofocal IOL be more effective without the additional expense? This study highlighted that in this platform of lenses, one should ask carefully about near-vision expectations.