Enhanced IOLs Improve Intermediate Vision, Quality of Life

Phaco tip being inserted into eye of patient with cataract, A phaco tip emits an ultrasonic wave that emulsifys the lens nucleus. As it breaks it down, a small hole in the tip suctions out the cataract, leaving the posterior capsule in contact. (Photo by Universal Images Group via Getty Images)
Enhanced IOL recipients reported feeling safer walking on uneven surfaces and could better recognize faces, research shows.

After undergoing cataract surgery, patients who received an enhanced intraocular lens (IOL) reported more improved vision-based quality of life than patients who received standard IOLs, a study published in Clinical Ophthalmology shows.

This study used a convenience sampling approach to recruit 19 patients undergoing cataract surgery at Hospital de San Pau in Spain. Patients were stratified by receiving a standard aspheric monofocal IOL (n=6), or an enhanced monofocal IOL (n=6). Another 7 remained on a wait list. Vision-related quality of life was assessed during semi-structured interviews.

Patients were aged a mean 74.±6.82 years, 63.16% were women, and 5.26% were living alone.

Prior to surgery, patients reported difficulty completing tasks in the near vision range (such as threading a needle or performing do-it-yourself tasks), and particularly while reading, either as a leisure activity or when shopping (to see price tags and expiration dates). These difficulties resulted in feelings of disappointment, frustration, and sadness, according to the investigators.

In the intermediate range, such as watching television or using a computer, the patients reported having difficulties seeing faces or reading subtitles. Patients endorsed feelings of fear and insecurity as well as physical symptoms of headache.

For distant vision, patients were concerned with safety when driving at night or during problematic weather. Some patients had difficulty enjoying sporting events due to vision problems.

After the surgery, patients who received both standard and enhanced IOLs reported improvements in near and distant vision, expressing satisfaction with seeing things clearer and were able to drive more safely.

For the intermediate visual range, however, only patients who received an enhanced IOL reported improvements. Enhanced IOL recipients reported feeling safer walking on uneven surfaces, they enjoyed watching television again, and they could recognize faces which was important for maintaining social quality of life.

The major limitation of this study was the reliance on anecdotal perspectives and not quantifying visual measures.

This exploratory qualitative study found that patients who received an enhanced IOL during cataract surgery reported quality of life improvements in near, intermediate, and distant vision. Recipients of a standard IOL reported fewer improvements to intermediate vision tasks. Additional study of vision-related quality of life in the cataract setting is needed.

Disclosure: Multiple authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Alias SB, Carrasco ZDC, Salvador-Miras I, et al. Exploring vision-related quality of life: a qualitative study comparing patients’ experience of cataract surgery with a standard monofocal IOL and an enhanced monofocal IOL. Clin Ophthalmol. 2022;16:1641-1652. doi:10.2147/OPTH.S358386