Clinical outcomes after mix-and-match implantation of monofocal and refractive multifocal intraocular lenses after surgery

Purpose To analyze the visual acuity, visual quality, and stereoscopic function of patients with binocular cataracts following mixed refractive multifocal intraocular lens (MIOL) (Lentis Comfort LS-313 MF15; Oculentis GmbH, Germany) and monofocal IOL (Tecnis ZCB00; Johnson & Johnson Vision, USA) implantation. Setting The study was conducted at the Eye Center of our hospital between January 2023 and December 2023. Design This was a retrospective, case–control study. Methods This retrospective study compared mixed implantation (LS-313 MF15 in non-dominant eye + ZCB00 in dominant eye, n = 30) versus bilateral monofocal implantation (ZCB00, n = 30). Visual acuity (uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA)), defocus curves, stereopsis, and patient-reported outcomes were assessed at 3 months. Results Sixty patients (120 eyes) were enrolled. Group A exhibited significantly better UIVA ( p < 0.001) and UNVA ( p < 0.001) than Group B. The defocus curve indicated more continuous visual acuity in Group A, which had a significantly better postoperative VF-14 (Visual Function Index-14) score ( p < 0.001) and spectacle independence rate than Group B. Near-stereoscopic acuity measured using Titmus card showed clearer stereoscopic vision in Group A than in Group B, with a significant difference ( p < 0.001). Conclusion Hybrid monovision may be an effective approach for patients with binocular cataracts since the concept of partial monovision is well-suited for the desire of eyeglass independence.