Visual Outcomes and Reading Performance of a Non-Diffractive EDOF IOL in Chinese Eyes: A Prospective Comparison of Emmetropia and Mini-Monovision Targets

Purpose: To evaluate the visual outcomes, reading performance, and patient satisfaction following bilateral implantation of a non-diffractive extended depth-of-focus (EDOF) intraocular lens (IOL) in Chinese eyes, and to compare the efficacy of emmetropia versus mini-monovision targets. Patients and Methods: This prospective, multi-center, observational study included 72 patients (144 eyes) who underwent phacoemulsification with bilateral implantation of the AcrySof IQ Vivity IOL (or Toric model). Patients were divided into two groups based on the refractive target: emmetropia (n=29) and mini-monovision (n=43). At 3 months postoperatively, binocular uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities were assessed. Functional outcomes were evaluated using the International Reading Speed Test (IReST), the Questionnaire for Visual Disturbances (QUVID), and the Intraocular Lens Satisfaction (IOLSAT) questionnaire. Results: At 3 months, both groups achieved excellent binocular uncorrected distance visual acuity (emmetropia: 0.03 ± 0.06 logMAR; mini-monovision: 0.05 ± 0.06 logMAR) and uncorrected intermediate visual acuity (emmetropia: 0.12 ± 0.14 logMAR; mini-monovision: 0.13 ± 0.14 logMAR). No statistically significant differences were observed in binocular UIVA (p=0.317) or UNVA (p=0.684) between the emmetropia and mini-monovision groups, although the mini-monovision group demonstrated significantly higher rates of spectacle independence (89.2% vs. 70.4%, p = 0.049). The mean reading speed improved significantly from 172 ± 67 wpm preoperatively to 201 ± 58 wpm postoperatively (p