ArticleClinical ophthalmology (Auckland, N.Z.)2026
Patient-Reported Outcomes After Bilateral Implantation of Monofocal versus Monofocal-Plus Toric Intraocular Lenses.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To compare patient-reported outcomes and visual performance after implantation of a conventional monofocal toric intraocular lens (Clareon, Alcon) versus a monofocal-plus toric intraocular lens (Eyehance, Johnson & Johnson Vision). Design: Single-center retrospective observational study with cross-sectional postoperative survey. Setting: Vance Thompson Vision, West Fargo, North Dakota. Methods: Patients who underwent bilateral cataract surgery between 2020 and 2025 with monofocal (Clareon) or monofocal-plus (Eyehance) toric IOLs were included. Chart data included uncorrected and best-corrected visual acuities, lens power, prior LASIK, and postoperative YAG capsulotomy or laser fine-tune. Eligible patients completed an 11-question telephone survey assessing satisfaction, glare/haloes, spectacle use across visual tasks, and willingness to choose the same lens again. Differences between groups were analyzed using Fisher's exact, Chi-square, and Wilcoxon rank-sum tests. Multivariable ordinal logistic regression evaluated independent predictors of satisfaction. Results: In total, 92 patients completed the survey (response rate 83.6%). Distance UCVA and BCVA were excellent and not significantly different between groups. Eyehance patients demonstrated better near UCVA (p < 0.001), consistent with its optical design. Spectacle independence across intermediate and near tasks was broadly similar, showing only a non-significant trend toward greater independence for computer use in the Eyehance group. Eyehance patients reported glare more frequently (p = 0.034), but glare-related bother remained low and did not differ significantly between groups. Clareon patients reported being "very satisfied" more frequently (p < 0.001), but adjusted ordinal regression showed higher overall satisfaction odds in the Eyehance group (adjusted OR 2.11, 95% CI 1.08-4.18, p = 0.031). Conclusion: Both toric IOL platforms provided excellent distance vision and favorable patient-reported outcomes. The monofocal-plus Eyehance design offered superior uncorrected near vision with increased glare frequency, without significant differences in glare bother between groups. These findings support individualized counseling and shared decision-making when choosing between conventional monofocal and monofocal-plus toric IOLs.
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