Purpose: This study aims to compare the 3-month clinical outcomes between two enhanced monofocal intraocular lenses (IOLs) following cataract surgery. Setting: Eye Clinic of Careggi University Hospital, Florence, Italy. Design: Single-center prospective study. Methods: We included patients with cataract and corneal astigmatism less than 0.75 D, with no ocular comorbidities, who underwent unilateral cataract surgery with implantation of either the Tecnis Eyhance ICB00 ( N = 25) or Evolux ( N = 25) IOLs. Standard cataract procedures were performed without complications. The main outcome measures included uncorrected and corrected visual acuity at distance (4 m), intermediate (60 cm) and near (40 cm) at 3-month follow-up. Additionally, monocular defocus curves, aberrometric profiles, and perceptions of halo and glare were evaluated. Results: The study involved 50 patients (26 male, 24 female) with a mean age of 68 ± 8 years. Preoperative characteristics were similar between the groups, and no intraoperative or postoperative complications were reported. Statistically significant differences were observed between the groups, with the Evolux IOL showing superior results ( p < 0.05) in terms of uncorrected and corrected visual acuity at near, intermediate, and distance, as well as in aberrometric profiles (lower-order aberration root-mean-square [RMS], higher-order aberration RMS, spherical equivalent RMS, and point spread function) and defocus curves. Conclusions: Based on our experience, while both IOLs offer substantial visual performance for intermediate and distance vision, the Evolux IOL demonstrated superior mean visual outcomes and objective parameters at the 3-month follow-up compared to the Tecnis Eyhance IOL. This indicates a potential advantage of the Evolux IOL in providing better visual performance.

Purpose: To describe an atypical phenotypic pattern of late-onset retinitis pigmentosa (RP) due to the same specific c.425A>G (p.Tyr142Cys) heterozygous mutation in the cone–rod homeobox gene (CRX gene) in two unrelated Italian patients. Case 1: A 67-year-old woman (P.P.) was incidentally diagnosed with sector RP at the age of 50. The patient was initially asymptomatic and did not have any family history of retinal dystrophy. Fundus examination showed the presence of typical retinal pigmentary deposits with a peculiar pericentral/sector distribution. Genomic sequencing disclosed the missense mutation c.425A>G (p.Tyr142Cys) in the CRX gene. During the follow-up period of 7 years, the patient maintained good visual acuity and complained only of mild symptoms. Case 2: A 76-year-old man (P.E.) presented with nyctalopia and visual field constriction since the age of 50. Fundus examination showed the presence of retinal pigment deposits with a concentric pericentral and perimacular pattern. A full-field electroretinogram (ffERG) showed extinguished scotopic responses and reduced abnormal photopic and flicker cone responses. Genomic sequencing identified the same missense mutation, c.425A>G (p.Tyr142Cys), in the CRX gene. Similarly to the first case, during the whole follow-up of 7 years, the visual acuity remained stable, as did the visual field and the patient’s symptoms. Conclusions: We report the first cases of late-onset retinitis pigmentosa related to a specific heterozygous CRX gene mutation in exon 4. We also report two atypical phenotypic RP patterns related to mutations in the CRX gene.