Functional Intermediate Vision After Bilateral Cataract Surgery with a Monofocal Intraocular Lens: A Prospective Binocular Evaluation at 80 cm

Functional Intermediate Vision After Bilateral Cataract Surgery with a Monofocal Intraocular Lens: A Prospective Binocular Evaluation at 80 cm | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Functional Intermediate Vision After Bilateral Cataract Surgery with a Monofocal Intraocular Lens: A Prospective Binocular Evaluation at 80 cm Libor Hejsek, Věra Veliká, David Beran, Pavel Rozsíval, Tereza Pařilová This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8776324/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose To evaluate binocular uncorrected intermediate visual acuity at 80 cm and overall visual outcomes after bilateral cataract surgery with implantation of a monofocal intraocular lens under emmetropic targeting. The primary aim was to assess whether a standard monofocal lens can provide functionally relevant intermediate vision under natural binocular viewing conditions. Methods This prospective, single-center observational study included 13 patients (26 eyes) undergoing bilateral cataract surgery with bilateral implantation of a monofocal intraocular lens. Visual outcomes were evaluated three months after second-eye surgery. The primary outcome was binocular uncorrected intermediate visual acuity at 80 cm. Secondary outcomes included monocular uncorrected and best-corrected distance visual acuity, monocular defocus curves with distance correction, and refractive predictability assessed by comparison of planned and achieved spherical equivalent. Data were analyzed using non-parametric statistics and Bland–Altman agreement analysis. Results Median monocular uncorrected distance visual acuity improved from 0.60 [IQR 0.30–1.00] logMAR preoperatively to 0.05 [0.00–0.10] logMAR postoperatively. Median binocular uncorrected intermediate visual acuity at 80 cm was 0.10 [0.10–0.20] logMAR; all patients achieved 0.30 logMAR or better. The defocus curve demonstrated functional visual performance from distance to approximately 66 cm. Postoperative refractive outcomes showed high predictability, with 85% of eyes within ± 0.50 D of the intended target. No intraoperative complications occurred. Conclusion Bilateral implantation of a monofocal intraocular lens under emmetropic targeting provided excellent distance vision and clinically meaningful binocular intermediate visual acuity at 80 cm. These findings suggest that selected monofocal lenses may reduce dependence on intermediate spectacles without the optical trade-offs associated with multifocal or extended-depth designs. Ophthalmology Cataract Surgery Intraocular Lenses Binocular Vision Refractive Predictability Defocus Curve Full Text Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryTableS1.docx Single Eye Parametres SupplementaryFig.S1.tif Cumulative distribution of postoperative monocular uncorrected distance visual acuity (UDVA) expressed in decimal notation for all eyes. SupplementaryFig.S2.tif Per-eye comparison of planned and achieved postoperative spherical equivalent three months after surgery. T SupplementaryTableS1.docx Single Eye Parametres Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8776324","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":585085060,"identity":"1978eb5b-c940-41f1-81d5-6779a3d847a9","order_by":0,"name":"Libor Hejsek","email":"","orcid":"","institution":"University Hospital Hradec Králové; Charles University, Faculty of Medicine in Hradec Králové","correspondingAuthor":false,"prefix":"","firstName":"Libor","middleName":"","lastName":"Hejsek","suffix":""},{"id":585085061,"identity":"f0defbe5-27cc-4906-8ff0-1b5ba217c236","order_by":1,"name":"Věra Veliká","email":"","orcid":"","institution":"University Hospital Hradec Králové; 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T\u003c/p\u003e","description":"","filename":"SupplementaryFig.S2.tif","url":"https://assets-eu.researchsquare.com/files/rs-8776324/v1/79c608bf286fc9acd28dfb3d.tif"},{"id":101876139,"identity":"a821f86e-40f0-4b0c-9b4f-f470c5bcb198","added_by":"auto","created_at":"2026-02-04 14:12:24","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":17833,"visible":true,"origin":"","legend":"\u003cp\u003eSingle Eye Parametres\u003c/p\u003e","description":"","filename":"SupplementaryTableS1.docx","url":"https://assets-eu.researchsquare.com/files/rs-8776324/v1/2f244e25ee704f75526415b6.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eFunctional Intermediate Vision After Bilateral Cataract Surgery with a Monofocal Intraocular Lens: A Prospective Binocular Evaluation at 80 cm\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[{"identity":"f9a76377-df2c-44c4-af5a-75a2ce2d65ab","identifier":"10.13039/100007397","name":"Univerzita Karlova v Praze","awardNumber":"Cooperatio (research areas Surgical Disciplines and Health Sciences)","order_by":0},{"identity":"7b4408d8-bc6e-41d2-9354-3f91b3bd0780","identifier":"10.13039/501100001823","name":"Ministerstvo Školství, Mládeže a Tělovýchovy","awardNumber":"SVV-2025-260776","order_by":1}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Charles University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cataract Surgery, Intraocular Lenses, Binocular Vision, Refractive Predictability, Defocus Curve","lastPublishedDoi":"10.21203/rs.3.rs-8776324/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8776324/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eTo evaluate binocular uncorrected intermediate visual acuity at 80 cm and overall visual outcomes after bilateral cataract surgery with implantation of a monofocal intraocular lens under emmetropic targeting. The primary aim was to assess whether a standard monofocal lens can provide functionally relevant intermediate vision under natural binocular viewing conditions.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis prospective, single-center observational study included 13 patients (26 eyes) undergoing bilateral cataract surgery with bilateral implantation of a monofocal intraocular lens. Visual outcomes were evaluated three months after second-eye surgery. The primary outcome was binocular uncorrected intermediate visual acuity at 80 cm. Secondary outcomes included monocular uncorrected and best-corrected distance visual acuity, monocular defocus curves with distance correction, and refractive predictability assessed by comparison of planned and achieved spherical equivalent. Data were analyzed using non-parametric statistics and Bland\u0026ndash;Altman agreement analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMedian monocular uncorrected distance visual acuity improved from 0.60 [IQR 0.30\u0026ndash;1.00] logMAR preoperatively to 0.05 [0.00\u0026ndash;0.10] logMAR postoperatively. Median binocular uncorrected intermediate visual acuity at 80 cm was 0.10 [0.10\u0026ndash;0.20] logMAR; all patients achieved 0.30 logMAR or better. The defocus curve demonstrated functional visual performance from distance to approximately 66 cm. Postoperative refractive outcomes showed high predictability, with 85% of eyes within \u0026plusmn;\u0026thinsp;0.50 D of the intended target. No intraoperative complications occurred.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eBilateral implantation of a monofocal intraocular lens under emmetropic targeting provided excellent distance vision and clinically meaningful binocular intermediate visual acuity at 80 cm. These findings suggest that selected monofocal lenses may reduce dependence on intermediate spectacles without the optical trade-offs associated with multifocal or extended-depth designs.\u003c/p\u003e","manuscriptTitle":"Functional Intermediate Vision After Bilateral Cataract Surgery with a Monofocal Intraocular Lens: A Prospective Binocular Evaluation at 80 cm","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-04 14:10:07","doi":"10.21203/rs.3.rs-8776324/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4aee7366-20f4-4fd2-8957-a68b08f802ec","owner":[],"postedDate":"February 4th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":62244326,"name":"Ophthalmology"}],"tags":[],"updatedAt":"2026-02-04T14:10:08+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-04 14:10:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8776324","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8776324","identity":"rs-8776324","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}