Comparing an Advanced Monofocal With a Non-diffractive Extended Depth of Focus Intraocular Lens Using a Mini-Monovision Approach

center dot PURPOSE: To compare interindividual differences in visual performance of an advanced monofocal with a non- diffractive extended depth of focus intraocular lens (IOL) using a mini-monovision approach. center dot DESIGN: Single-center, randomized, controlled, double- masked study. center dot METHODS: In total, 48 patients (96 eyes) with bilateral age-related cataract were enrolled. One group received an advanced monofocal IOL RAO200E (RayOne EMV; Rayner) and the other group a non-diffractive extended depth of focus IOL DFT015 (Acrysof IQ Vivity; Alcon) in both eyes. Target refraction for both groups was mini-monovision. After 3 months, monocular and binocular distance corrected and uncorrected distance (CDVA/UDVA), intermediate (DCIVA/UIVA), and near visual acuity (DCNVA/UNVA); contrast sensitivity; binocular defocus curves; halometry; and Quality of Vision questionnaire scores were compared. center dot RESULTS: Binocular mean CDVA, DCIVA at 66 cm, and DCNVA at 40 cm were-0.10 +/- 0.10, 0.15 +/- 0.11, and 0.32 +/- 0.16 logMAR for the RAO200E and- 0.10 +/- 0.10, 0.12 +/- 0.10, and 0.27 +/- 0.16 logMAR for the DFT015, respectively, with no significant difference. A significant difference could be shown for the dominant eye in monocular DCIVA and DCNVA and for the dominant and nondominant eye in monocular UNVA, with 0.28 +/- 0.14, 0.48 +/- 0.22, 0.46 +/- 0.21, and 0.41 +/- 0.20 log- MAR for the RAO200E and 0.14 +/- 0.10 ( P = .023), 0.35 +/- 0.16 ( P = .008), 0.30 +/- 0.14 ( P = .001), and 0.21 +/- 0.10 ( P = .003) logMAR for the DFT015, respectively. Significantly smaller halo size in the RAO200E group and significantly better distance-corrected defocus curve at-2.5 ( P = .031),-2.0 ( P = .03), and-1 diopters ( P = .03) of defocus in the DFT015 group could be shown. center dot CONCLUSIONS: Distance corrected or uncorrected binocular visual acuity for far, intermediate, and near distance between the advanced monofocal IOL RAO200E and the non-diffractive extended depth of focus IOL DFT015, when compared in a mini-monovision setting, showed no significant differences. (Am J Ophthalmol 2025;271: 86-95. (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc- nd/4.0/))