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Randomized contralateral comparison of visual outcomes following implantation of two monofocal aspherical intraocular lenses after cataract surgery

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To compare optical and visual performances of two one-piece aspherical implanted intraocular lenses (IOLs) following phacoemulsification cataract surgery in a contralateral eye study.


In this prospective randomized parallel-group study, 25 patients with bilateral age-related cataract were implanted in one eye with the EnVista IOL (MX60, Bausch & Lomb Corporations, Rochester, NY, USA) and the Acrysof IQ IOL (Acrysof IQ SN60WF, Alcon Surgical Laboratories, Fort Worth, TX, USA) in the other eye. Uncorrected and corrected distance visual acuity (UDVA, CDVA), refractive status, higher-orders aberrations (HOAs) in 5 and 6 mm pupil size, contrast sensitivity (CS) with and without glare, color vision status, and patient satisfaction were assessed in the two eyes at 1 and 3 months after surgery.


There was no significant difference in CDVA (P > 0.99), UDVA (P = 0.46), spherical equivalent refractive error (P = 0.63), CS with and without glare across different spatial frequencies, color vision, and root mean square (RMS) of aberrometric values between the two IOLs after 3-month follow-up. Spherical aberration with 5 and 6 mm pupil sizes (P = 0.02) and horizontal coma with a 6 mm pupil size (P < 0.001) were lower with the EnVista IOL. Patient’s satisfaction showed no cases of dissatisfaction, and most patients were highly or moderately satisfied with both IOLs.


The visual and optical performance of eyes implanted with the EnVista IOL or the Acrysof IQ IOL was similar, although the aberration profile differed.

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  1. Vashist P, Talwar B, Gogoi M, Maraini G, Camparini M, Ravindran RD, Murthy GV, Fitzpatrick KE, John N, Chakravarthy U, Ravilla TD, Fletcher AE (2011) Prevalence of cataract in an older population in India: the India study of age-related eye disease. Ophthalmology 118(272–278):e271–272.

    Article  Google Scholar 

  2. Wong TY, Loon SC, Saw SM (2006) The epidemiology of age related eye diseases in Asia. Br J Ophthalmol 90:506–511.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Pérez GM, Manzanera S, Artal P (2009) Impact of scattering and spherical aberration in contrast sensitivity. J Vis 9: 19.11–10.

  4. Thibos LN, Bradley A, Zhang XX (1991) Effect of ocular chromatic aberration on monocular visual performance. Optom Vis Sci 68:599–607.

    Article  CAS  PubMed  Google Scholar 

  5. Kasper T, Buhren J, Kohnen T (2006) Visual performance of aspherical and spherical intraocular lenses: intraindividual comparison of visual acuity, contrast sensitivity, and higher-order aberrations. J Cataract Refract Surg 32:2022–2029.

    Article  PubMed  Google Scholar 

  6. Modjtahedi BS, Hull MM, Adams JL, Munz SJ, Luong TQ, Fong DS (2019) Preoperative vision and surgeon volume as predictors of visual outcomes after cataract surgery. Ophthalmology 126:355–361.

    Article  PubMed  Google Scholar 

  7. Nabh R, Ram J, Pandav SS, Gupta A (2009) Visual performance and contrast sensitivity after phacoemulsification with implantation of aspheric foldable intraocular lenses. J Cataract Refract Surg 35:347–353.

    Article  PubMed  Google Scholar 

  8. Panagiotopoulou EK, Ntonti P, Vlachou E, Georgantzoglou K, Labiris G (2018) Patients' expectations in lens extraction surgery: a systematic review. Acta Medica (Hradec Kralove) 61:115–124.

  9. Hawker MJ, Madge SN, Baddeley PA, Perry SR (2005) Refractive expectations of patients having cataract surgery. J Cataract Refract Surg 31:1970–1975.

    Article  PubMed  Google Scholar 

  10. Schuster AK, Tesarz J, Vossmerbaeumer U (2013) The impact on vision of aspheric to spherical monofocal intraocular lenses in cataract surgery: a systematic review with meta-analysis. Ophthalmology 120:2166–2175

    Article  Google Scholar 

  11. Lin IC, Wang IJ, Lei MS, Lin LL, Hu FR (2008) Improvements in vision-related quality of life with AcrySof IQ SN60WF aspherical intraocular lenses. J Cataract Refract Surg 34:1312–1317.

    Article  PubMed  Google Scholar 

  12. Norrby S, Piers P, Campbell C, van der Mooren M (2007) Model eyes for evaluation of intraocular lenses. Appl Opt 46:6595–6605

    Article  Google Scholar 

  13. Heiner P, Ligabue E, Fan A, Lam D (2014) Safety and effectiveness of a single-piece hydrophobic acrylic intraocular lens (enVista®)–results of a European and Asian-Pacific study. Clin Ophthalmol 8:629–635

    Article  Google Scholar 

  14. Packer M, Fry L, Lavery KT, Lehmann R, McDonald J, Nichamin L, Bearie B, Hayashida J, Altmann GE, Khodai O (2013) Safety and effectiveness of a glistening-free single-piece hydrophobic acrylic intraocular lens (enVista). Clin Ophthalmol 7:1905–1912.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Madrid-Costa D, Ruiz-Alcocer J, Ferrer-Blasco T, Garcia-Lazaro S, Montes-Mico R (2014) In vitro optical performance of a new aberration-free intraocular lens. Eye (Lond) 28:614–620.

    Article  CAS  Google Scholar 

  16. Waite A, Faulkner N, Olson RJ (2007) Glistenings in the single-piece, hydrophobic, acrylic intraocular lenses. Am J Ophthalmol 144:143–144

    Article  Google Scholar 

  17. Colin J, Praud D, Touboul D, Schweitzer C (2012) Incidence of glistenings with the latest generation of yellow-tinted hydrophobic acrylic intraocular lenses. J Cataract Refract Surg 38:1140–1146

    Article  Google Scholar 

  18. Minami H (1999) Glistening of the acrylic intraocular lenses. Jpn J Ophthalmol 53:991–994

    Google Scholar 

  19. Özdek SC, Onaran Z, Gürelik G, Konuk O, Tekinsen A, Hasanreisoglu B (2005) Bilateral endophthalmitis after simultaneous bilateral cataract surgery. J Cataract Refract Surg 31:1261–1262.

    Article  PubMed  Google Scholar 

  20. Puvanachandra N, Humphry RC (2008) Bilateral endophthalmitis after bilateral sequential phacoemulsification. J Cataract Refract Surg 34:1036–1037.

    Article  PubMed  Google Scholar 

  21. Dain SJ, Atchison DA, Hovis JK (2019) Limitations and precautions in the use of the Farnsworth-Munsell dichotomous D-15 Test. Optom Vis Sci 96:695–705.

    Article  PubMed  Google Scholar 

  22. Tester R, Pace NL, Samore M, Olson RJ (2000) Dysphotopsia in phakic and pseudophakic patients: incidence and relation to intraocular lens type(2). J Cataract Refract Surg 26:810–816.

    Article  CAS  PubMed  Google Scholar 

  23. Rocha KM, Soriano ES, Chalita MR, Yamada AC, Bottós K, Bottós J, Morimoto L, Nosé W (2006) Wavefront analysis and contrast sensitivity of aspheric and spherical intraocular lenses: a randomized prospective study. Am J Ophthalmol 142:750–756.

    Article  PubMed  Google Scholar 

  24. Unsal U, Sabur H (2020) Comparison of new monofocal innovative and standard monofocal intraocular lens after phacoemulsification. Int Ophthalmol 41:273–282.

    Article  PubMed  Google Scholar 

  25. Yadav S, Sahay P, Maharana PK, Titiyal JS, Vajpayee RB, Sharma N (2017) Comparison of visual performance and after cataract formation between two monofocal aspheric intraocular lenses following phacoemulsification for senile cataract: a randomized controlled study. Indian J Ophthalmol 65:1445–1449.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Yamaguchi T, Dogru M, Yamaguchi K, Ono T, Saiki M, Okuyama H, Tsubota K, Negishi K (2009) Effect of spherical aberration on visual function under photopic and mesopic conditions after cataract surgery. J Cataract Refract Surg 35:57–63

    Article  Google Scholar 

  27. Jafarinasab MR, Shirzadeh E, Feizi S, Karimian F, Akaberi A, Hasanpour H (2015) Sensitivity and specificity of posterior and anterior corneal elevation measured by orbscan in diagnosis of clinical and subclinical keratoconus. J Ophthalmic Vis Res 10:10–15

    Article  Google Scholar 

  28. Lee K, Yoon MH, Seo KY, Kim EK, Kim T-i (2013) Comparisons of clinical results after implantation of three aspheric intraocular lenses. J Korean Ophthalmol Soc 54:1213–1218

    Article  Google Scholar 

  29. Park YS, Ji YS, Yoon KC (2016) Comparison of clinical long-term outcomes with two types of one-piece Aspheric intraocular lenses after cataract surgery. J Korean Ophthalmol Soc 57:221–227

    Article  Google Scholar 

  30. Packer M, Rajan M, Ligabue E, Heiner P (2014) Clinical properties of a novel, glistening-free, single-piece, hydrophobic acrylic IOL. Clin Ophthalmol 8:421–427.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Oshika T, Shiokawa Y, Amano S, Mitomo K (2001) Influence of glistenings on the optical quality of acrylic foldable intraocular lens. Br J Ophthalmol 85:1034–1037

    Article  CAS  Google Scholar 

  32. Morris C, Werner L, Barra D, Liu E, Stallings S, Floyd A (2014) Light scattering and light transmittance of cadaver eye-explanted intraocular lenses of different materials. J Cataract Refract Surg 40:129–137.

    Article  PubMed  Google Scholar 

  33. Denoyer A, Denoyer L, Halfon J, Majzoub S, Pisella P-J (2009) Comparative study of aspheric intraocular lenses with negative spherical aberration or no aberration. J Cataract Refract Surg 35:496–503

    Article  Google Scholar 

  34. Mönestam E, Behndig A (2016) Change in light scattering caused by glistenings in hydrophobic acrylic intraocular lenses from 10 to 15 years after surgery. J Cataract Refract Surg 42:864–869

    Article  Google Scholar 

  35. Altmann GE, Nichamin LD, Lane SS, Pepose JS (2005) Optical performance of 3 intraocular lens designs in the presence of decentration. J Cataract Refract Surg 31:574–585

    Article  Google Scholar 

  36. Wang L, Koch DD (2005) Effect of decentration of wavefront-corrected intraocular lenses on the higher-order aberrations of the eye. Arch Ophthalmol 123:1226–1230

    Article  Google Scholar 

  37. Padmanabhan P, Rao SK, Jayasree R, Chowdhry M, Roy J (2006) Monochromatic aberrations in eyes with different intraocular lens optic designs. J Refract Surg 22:172–177

    Article  Google Scholar 

  38. Wirtitsch MG, Schmidinger G, Prskavec M, Rubey M, Skorpik F, Heinze G, Findl O, Karnik N (2009) Influence of blue-light-filtering intraocular lenses on color perception and contrast acuity. Ophthalmology 116:39–45

    Article  Google Scholar 

  39. Leibovitch I, Lai T, Porter N, Pietris G, Newland H, Selva D (2006) Visual outcomes with the yellow intraocular lens. Acta Ophthalmol Scand 84:95–99

    Article  Google Scholar 

  40. Cionni RJ, Tsai JH (2006) Color perception with AcrySof Natural and AcrySof single-piece intraocular lenses under photopic and mesopic conditions. J Cataract Refract Surg 32:236–242

    Article  Google Scholar 

  41. Wohlfart C, Tschuschnig K, Fellner P, Weiss K, Vidic B, El-Shabrawi Y, Ardjomand N (2007) Visuelle Funktion mit Blaulichtfilter-IOL. Klin Monbl Augenheilkd 224:23–27

    Article  CAS  Google Scholar 

  42. Eberhard R, Roberti P, Prünte C (2009) Intraindividual comparison of color perception and contrast sensitivity with and without a blue light-filtering intraocular lens. Eur J Ophthalmol 19:235–239

    Article  Google Scholar 

  43. Bender LE, Nimsgern C, Jose R, Jayaram H, Spalton DJ, Tetz MR, Packard RB, Meacock W, Boyce J (2004) Effect of 1-piece and 3-piece AcrySof intraocular lenses on the development of posterior capsule opacification after cataract surgery. J Cataract Refract Surg 30:786–789.

    Article  PubMed  Google Scholar 

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The authors would like to thank the participants who made this study possible and possible and the Deputy of Research of Mashhad University of Medical Sciences.



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Correspondence to Hamed Momeni-Moghaddam.

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This research was approved by the ethical committee of Deputy of Research of Mashhad University of Medical Sciences (Code No.: 4452284).

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Zarei-Ghanavati, S., Monfared, N., Heravian, J. et al. Randomized contralateral comparison of visual outcomes following implantation of two monofocal aspherical intraocular lenses after cataract surgery. Int Ophthalmol 42, 1563–1571 (2022).

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