Biometric Indicators for Maximizing Intermediate Vision with a Monofocal IOL

Abstract

Purpose

To determine refractive or biometric variables that might be predictive of increased intermediate vision in patients receiving an Eyhance monofocal intraocular lens (IOL).

Methods

This prospective, single-center, bilateral, non-randomized, open-label, observational study included a total of 110 subjects (220 eyes). Subjects had been previously bilaterally implanted with an Eyhance monofocal IOL (Johnson & Johnson Vision Care, Inc.) and were later divided into 2 groups based on their postoperative visual acuity. Subjects that had binocular distance corrected intermediate visual acuity (DCIVA) of 0.2 logMAR or better were classified into the Enhanced Group, and the remaining subjects were classified into the Non-Enhanced Group. Refractive outcomes and biometric measurements were compared between groups.

Results

The number of subjects in each group was 61 for the Enhanced Group, and 49 for the Non-Enhanced Group. There were significant differences in pupil size between groups, with pupil sizes in the Enhanced Group significantly smaller than in the Non-Enhanced Group (p < 0.01). Subjects also reported significantly more dysphotopsias in the Non-Enhanced Group compared to the Enhanced Group (p = 0.03). Multiple regression analysis identified pupil size and axial length as significant predictors of increased monocular intermediate vision.

Conclusion

The results of this study suggest that pupil size could be a predictor of increased intermediate vision in a patient receiving an Eyhance monofocal IOL.

Plain Language Summary

Cataract surgery involves removing an opaque natural lens and replacing it with a clear artificial lens. These artificial lenses are called intraocular lenses (IOLs). There are many different types of IOLs, and each type provides varying degrees of clear vision at far, intermediate, and near distances. Clear vision at intermediate distance is especially important for viewing digital devices. One type of monofocal IOL, the Eyhance (Johnson & Johnson Vision Care, Inc.) was designed to improve the depth of focus. However, it is not well understood why some patients experience increased intermediate vision and some patients do not. The purpose of this study was to determine refractive or biometric variables that might be predictive of increased intermediate vision in patients receiving an Eyhance monofocal IOL. The results of this study suggest that pupil size could be a predictor of increased intermediate vision, and patients with smaller pupils may be more likely to experience increased intermediate vision.

Keywords:

• cataract surgery
• Eyhance
• aspheric
• intermediate visual acuity

Acknowledgments

This paper was presented at the 2023 American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting as a conference talk with interim findings.

Disclosure

J. Morgan Micheletti, MD, is a consultant for Johnson & Johnson, and reports the following outside the submitted work: Alcon – Consultant, Speaker, Research Grant; Allergan – Consultant, Research Grant; Bausch & Lomb – Consultant; BVI – Consultant; Centricity – Consultant, Speaker; Lenstec – Speaker; RxSight – Consultant, Speaker; Zeiss – Consultant. Matthew B. McCauley, MD is a consultant for Alcon. Brad Hall reports consulting fees from Ace Vision Group outside the submitted work. The authors report no other conflicts of interest for this work.

Additional information

Funding

This study was supported with an unrestricted study grant from Johnson & Johnson, Jacksonville, FL, USA.