Enhanced Monofocal IOLs Improve Patient Satisfaction in Phaco-Vitrectomy for ERM

Purpose: Tecnis Eyhance (DIB00V) is a type of monofocal intraocular lens (IOL) categorized as “IOL-plus”, a new concept developed to improve not only distance but also intermediate vision. However, its negative effect, eg difficulty in macular surgery that is occasionally seen with the multifocal IOL, has not been ruled out in combined surgery for epiretinal membrane (ERM) and cataracts. This study aimed to compare DIB00V with a conventional monofocal IOL (DCB00V) in terms of visual acuity and patient-reported outcomes of combined surgery for epiretinal membrane (ERM) and cataracts. Methods: This was a multicenter, prospective, nonrandomized, observational study conducted in Japan. Patients scheduled for combined cataract and pars plana vitrectomy (PPV) for cataract and ERM were enrolled. IOL was selected according to the rules originally applied in each facility. Best-corrected distance visual acuity (BCDVA) and distance-corrected intermediate visual acuity (DCIVA) at 3-month visits postoperatively, surgical parameters, and Japanese-modified Catquest-9SF Questionnaire scores were compared between the two IOL groups. Results: Sixty-two eyes implanted with DCB00V (Tecnis-1) and 79 eyes implanted with DIB00V (Eyhance) were analyzed. There was no significant difference in BCDVA with Eyhance (0.09 in logMAR) and Tecnis-1 (0.05 in logMAR, p = 0.174), and DCIVA with Eyhance (0.35 in logMAR) and Tecnis-1 (0.39 in logMAR, p = 0.200). Rasch analysis of the Japanese-modified Catquest-9SF Questionnaire revealed that Eyhance scored higher in patients’ general satisfaction (p = 0.0269). Subgroup analysis revealed a better postoperative distance-corrected intermediate visual acuity in patients with a certain degree of preoperative myopia (spherical error < −1.5 diopter). Conclusion: Eyhance provided comparable postoperative visual acuity to the conventional monofocal IOL in combined surgery for cataract and ERM, and surgical parameters are not different in the two types of IOL. Furthermore, Eyhance improved postoperative satisfaction in the overall population and significantly improved intermediate visual acuity in the preoperatively myopic population.