Comparison of Visual and Refractive Outcomes Between Different Intraocular Lens Types Following Phacoemulsification

Open Access

Abstract

Background: Cataract is a common cause of visual impairment, and phacoemulsification with intraocular lens (IOL) implantation is widely used to restore vision. However, visual and refractive outcomes may vary depending on the type of IOL used. Objective: This study compared the visual and refractive outcomes of monofocal, multifocal, extended depth-of-focus (EDOF), and toric IOLs following phacoemulsification. Methods & Materials: This prospective comparative study was conducted in the Ophthalmology Department of Satkhira Medical College from April 2025 to March 2026. It included 100 patients undergoing uncomplicated phacoemulsification: 40 received monofocal IOLs, while 20 each received multifocal, EDOF, or toric IOLs. Visual acuity and refraction were assessed preoperatively and during 6 months of follow-up. Outcomes included UCVA, BCVA, spherical equivalent, residual astigmatism, target-refraction achievement, and postoperative complications. Results: Participants had a mean age of 61.8±8.7 years, and 58.0% were male. Visual acuity improved significantly in all groups at 6 months (p<0.001). Mean 6-month UCVA was 0.18±0.12, 0.13±0.09, 0.12±0.08, and 0.15±0.10 logMAR in the monofocal, multifocal, EDOF, and toric groups, respectively, with no significant between-group difference (p=0.071). Residual astigmatism was lowest in the toric group (−0.31±0.27 D; p=0.006). Spherical equivalent within ±0.50 D of target was achieved in 67.5%, 85.0%, 90.0%, and 85.0% of the respective groups (p=0.047). Overall, 82.0% had no postoperative complications. Conclusion: All four IOL types significantly improved vision after phacoemulsification. Toric IOLs reduced residual astigmatism, while EDOF IOLs showed favorable visual and refractive outcomes. Selection should reflect ocular characteristics, refractive status, and individual visual needs.