Purpose: to investigate the reproducibility and reliability of OCT-A vascular measurements using Heidelberg Spectralis II OCT-A. Methods: a prospective study involving a single eye of patients aged 18 or older with no ocular disease. In order to investigate the reliability of the first and second OCT-A scans, the coefficient of variation of the foveal avascular zone (FAZ) and the vessel density (VD) in the superficial (SCP), intermediate (ICP) and deep capillary plexus (DCP) were calculated. Results: A total of 75 eyes were included in the study. The mean FAZ in the first and second scan was 0.36 × 0.13 mm² and 0.37 × 0.12 mm², respectively, in the SCP, 0.23 × 0.10 mm² and 0.23 × 0.09 mm² in the ICP, and 0.42 × 0.11 mm² and 0.43 × 0.12 mm² in the DCP. The overall VD was 36.05 × 9.01 and 35.33 × 9.92 at the first and second scan, respectively, in the SCP, 21.87 × 5.00 and 21.32 × 5.56 in the ICP, and 23.84 × 6.53 and 23.20 × 6.83 in the DCP. No statistically significant differences in FAZ measurements and VD in all sectors of each capillary plexus were observed between the first and second scan (p > 0.05). Conclusion: our study demonstrated the good reproducibility and reliability of OCT-A vascular measurements in the analysis of the FAZ and the quantification of VD in each capillary plexus of the retina.

Background/Objectives: Enhanced monofocal intraocular lenses (IOLs) aim to extend functional vision into the intermediate range while preserving the distance visual quality of standard monofocal aspheric lenses. This study compared the clinical and patient-reported outcomes of two enhanced monofocal IOLs, TECNIS Eyhance™ and Evolux™, and characterised the anterior surface profile of the Evolux™ optic. Methods: This single-centre, retrospective comparative case series included consecutive patients who received bilateral implantation of either Evolux™ or TECNIS Eyhance™ between February and July 2023. Primary outcomes were monocular uncorrected and distance-corrected intermediate visual acuity (UIVA, DCIVA). Secondary outcomes included monocular and binocular distance and near visual acuity, binocular intermediate visual acuity, spherical equivalent and patient-reported outcomes assessed using the Revised Heidelberg Daily Task Evaluation (DATE) questionnaire. Equivalence testing, Welch’s t-test, and covariate-adjusted ANCOVA were performed. Anterior surface profilometry of the Evolux™ IOL was conducted using an optical profilometer. Results: A total of 44 patients were included, 14 in the Evolux™ group and 30 in the TECNIS Eyhance™ group. Monocular and binocular UIVA and DCIVA were statistically equivalent between groups (TOST p = 0.028, 0.016, 0.008, and 0.005, respectively). Monocular and binocular distance outcomes were likewise equivalent. Binocular distance-corrected near visual acuity was significantly better in the Evolux™ group (0.164 ± 0.084 vs. 0.233 ± 0.112 logMAR; p = 0.030; Cohen’s d = 0.661), without a corresponding monocular difference. This isolated finding should be interpreted cautiously given the exploratory, multiple-outcome analysis and because it did not retain statistical significance after covariate adjustment for baseline biometric imbalances. Conclusions: In this exploratory study, both IOLs showed no statistically significant differences in intermediate and distance visual outcomes at one month after second eye surgery. The unadjusted binocular near vision finding for Evolux™, which did not retain significance after covariate adjustment, warrants further investigation in prospective, adequately powered, biometrically balanced studies.