Background/Objectives: Enhanced monofocal and non-diffractive extended depth-of-focus (EDoF) intraocular lenses (IOLs) aim to improve intermediate vision while maintaining contrast sensitivity. However, direct comparative evidence under both photopic and mesopic conditions remains limited. This study prospectively compared the visual performance of two enhanced monofocal IOLs (Tecnis^® Eyhance^™ and ISOPure^®) and one non-diffractive EDoF IOL (AcrySof^® IQ Vivity^™). Methods: Sixty patients undergoing bilateral cataract surgery were implanted with one of three IOL groups (n = 20 each). Patients were assigned to one of three IOL groups based on preoperative consultation and clinical indications. One month postoperatively, monocular corrected distance (CDVA), distance-corrected intermediate (DCIVA), and near visual acuity (DCNVA) were measured under photopic and mesopic conditions. Photopic defocus curves, contrast sensitivity under photopic and mesopic conditions and correlation between pupil diameter and visual acuities were also assessed. Results: Baseline characteristics were comparable among groups. Under photopic conditions, Vivity^™ achieved significantly better UDVA, DCIVA and DCNVA than both Eyhance^™ and ISOPure^®. Under mesopic conditions, distance acuity did not differ significantly, but Vivity™ showed superior DCIVA and DCNVA. Defocus curves demonstrated a broader functional range of vision with Vivity™, while Eyhance^™ and ISOPure^® showed nearly overlapping profiles. Contrast sensitivity was similar among all IOLs under both lighting conditions, with no statistically significant differences. Conclusions: The non-diffractive EDoF AcrySof^® IQ Vivity^™ provided a wider and more functional depth-of-focus than the enhanced monofocal lenses evaluated, without compromising contrast sensitivity. Eyhance^™ and ISOPure^® offered comparable performance, with good distance vision and modest depth-of-focus extension. All three IOLs maintained CS levels comparable to those typically reported for standard monofocal IOLs under both photopic and mesopic illumination, indicating no clinically relevant contrast penalty.

Background/Objectives: Age-related macular degeneration (AMD) is a leading cause of visual impairment in older adults and often coexists with cataracts. The indication of presbyopia-correcting intraocular lenses (IOLs) in these patients remains controversial. This study aimed to evaluate the clinical performance of a non-diffractive extended depth-of-focus (EDOF) IOL (LuxSmart™) compared to a monofocal plus IOL (Tecnis Eyhance™) in cataract patients with early-stage dry AMD. Methods: In this prospective observational study, 41 patients with early-stage AMD underwent bilateral cataract surgery with either LuxSmart™ or Tecnis Eyhance™ IOL implantation, targeting postoperative emmetropia. The eye selected for analysis was the first eye scheduled for surgery. Preoperative and postoperative evaluations included high and low-contrast distance visual acuity, intermediate and near visual acuity, defocus curves, ocular light scatter (halometry), and quality of life assessment (NEI VFQ-25). Postoperative biometric accuracy and refractive outcomes were also analyzed. Results: Both IOLs showed high refractive accuracy, with 100% of eyes within ±0.50 D of target. Postoperative uncorrected distance visual acuity was 0.10 ± 0.06 LogMAR for Eyhance and 0.07 ± 0.02 for LuxSmart (p = 0.06). Low contrast VA at 20% was 0.22 ± 0.11 (Eyhance) and 0.26 ± 0.16 (LuxSmart) (p = 0.49). Depth of focus was approximately 1.75 D for both lenses. Light scatter (LDI) improved postoperatively in both groups with no significant differences (p = 0.54). VFQ-25 scores showed improvement in daily activities, though no changes were observed in driving or mental health domains. Conclusions: Both lenses are safe and effective options for early AMD patients undergoing cataract surgery, providing good functional vision at multiple distances