Spectacle Independence And Patient Satisfaction With Pseudophakic Mini-Monovision Using Aberration-Free Intraocular Lens

Abstract

Purpose

To assess spectacle independence and patient satisfaction with pseudophakic mini-monovision in patients undergoing routine bilateral cataract surgery with implantation of an aspherical aberration-free intraocular lens (Akreos AO, Bausch and Lomb, USA).

Methods

This study was a retrospective analysis that included 60 eyes of 30 consecutive patients between 2016 and 2018. The included patients had undergone sequential bilateral routine phacoemulsification after choosing the mini-monovision option. Test for ocular dominance was done using a sighting test. Emmetropia was aimed at in the dominant eye, while in the non-dominant eye the aim was myopia between −1 D and −1.5 D. The main outcome parameters were uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and data reported from a questionnaire given to the patients at 3 months postoperative visit.

Results

The study included 60 eyes of 30 consecutive patients. The mean binocular UDVA was 0.09 ± 0.07 logMAR. Twenty-eight patients (93%) had binocular UDVA of 0.2 logMAR or better. The mean binocular uncorrected intermediate distance visual acuity (at 65 cm) was 0.16 ± 0.12 logMAR. Twenty-six patients (87%) had binocular uncorrected intermediate distance visual acuity of 0.2 logMAR or better. The mean binocular UNVA (at 35 cm) was 0.30 ± 0.21 logMAR. Fourteen patients (47%) had binocular UNVA of 0.2 logMAR or better. The patients score in the questionnaire was significantly higher in far and intermediate vision than near vision (p = 0.022). The patients score was significantly higher in day vision than night vision (p = 0.031). The mean overall patient satisfaction was good (9.1 ± 1.54). Twenty-eight patients (93%) reported high spectacle independence for far vision (score 8, 9, or 10).

Conclusion

Pseudophakic mini-monovision shows good results for spectacle independence and high patient satisfaction. It is a safe and inexpensive option after bilateral cataract surgery for correcting distance and intermediate vision. However, it might show lower results with near and night vision which is generally acceptable. Using aberration-free monofocal IOL allows for the residual normal positive corneal aberration that may augment the effect of monovision.

Keywords:

• mini-monovision
• spectacle independence
• patient satisfaction
• pseudophakia
• presbyopia
• Akreos AO

Abbreviations

IOL, intraocular lens; EDOF, extended depth of focus; D, diopter; UDVA, uncorrected distance visual acuity; UNVA, uncorrected near visual acuity; OCT, optical coherence tomography; MRSE, manifest refraction spherical equivalent.

Ethics And Consent To Participate

The study was approved by the local ethics committee at the Faculty of Medicine, Alexandria University, Egypt. Tenets of the Declaration of Helsinki were followed. All included patients were recalled for a final follow up visit and signing of an informed consent. Informed consent was obtained from all individual participants included in the study.

Availability Of Data

Data are available upon reasonable request to the authors.

Author Contributions

Both authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.