PURPOSE: To evaluate the visual outcomes and quality of vision in patients receiving a nondiffractive extended depth of focus (EDOF) intraocular lens (IOL), when implanted in eyes with high ocular axial length (≥24.5 mm). METHODS: This was a prospective, single-arm, single-surgeon study. Subjects were bilaterally implanted with the Vivity EDOF IOL (toric and nontoric). At 3 months postoperatively, assessments included binocular and monocular visual acuities at distance (6 m), intermediate (66 cm), and near (40 cm), manifest refraction, and administration of a visual disturbance questionnaire (or QUVID) and a satisfaction questionnaire (or IOLSAT). RESULTS: At 3 months postoperatively, 100% (20/20), 100% (20/20), and 65% (13/20) of subjects had binocular visual acuity 20/32 or better at distance, intermediate, and near, respectively. Similar visual acuities were obtained with distance correction. At 3 months postoperatively, 93% of eyes (37/40) had manifest refraction spherical equivalent 0.5 D or less. Patient reported spectacle independence was 95% (19/20), 90% (18/20), and 40% (8/20) at distance, intermediate, and near, respectively. Patient-reported satisfaction with their corrected vision was 95% (19/20). In addition, 70% (14/20), 65% (13/20), and 70% (14/20) of subjects reported never or rarely experiencing starburst, halo, and glare, respectively. CONCLUSIONS: The results of this study suggest that the Vivity nontoric and toric IOLs can provide excellent distance and intermediate vision and functional near vision in eyes with high ocular axial length. Good spectacle independence can also be achieved at distance and intermediate, with high reported patient satisfaction and low reported visual disturbances.