Visual and Refractive Outcomes and Patient Satisfaction Following Implantation of Monofocal IOL in One Eye and ERV IOL in the Contralateral Eye with Mini-Monovision

Figures & data

Table 1 Demographic and Pre-Operative Data of Patients Included in the Study

Parameter	Monofocal IOL (Tecnis-1)	ERV IOL (Symfony)	p-value
	(n=25 Eyes)	(n=25 Eyes)
	Mean ± SD	Mean ± SD
Sphere (D)	−0.46±2.17	−0.33±2.07	0.82
Cylinder (D)	−0.22±0.73	−0.06±0.76	0.45
SE (D)	−0.57±2.40	−0.36±2.35	0.75
UDVA(LogMAR)	0.46 ± 0.28	0.44 ± 0.27	0.8
CDVA (LogMAR)	0.29 ± 0.16	0.32 ± 0.22	0.52
K1(D)	43.35 ± 1.23	43.19 ± 1.41	0.78
K2 (D)	44.20 ± 1.26	43.73 ± 1.42	0.9
Corneal astigmatism(D)	0.39 ± 0.39	0.31 ± 0.31	0.72
Axial length(mm)	23.56 ± 1.17	23. 6 ± 1.14	0.93
IOL power (D)	20.93 ± 3.26	21.86 ± 2.79	0.56

Abbreviations: D, dioptre; SE, spherical equivalent; UDVA, uncorrected distance visual acuity; CDVA, corrected distance visual acuity; K, keratometry.

Table 2 Binocular Visual Acuity Outcomes at 6 Months Post-Operatively

Parameter	Uncorrected	Distance Corrected	p-value
	(Mean± SD) [Range]	(Mean± SD) [Range]
Visual acuity (LogMAR)
Distance	0.007±0.07(UDVA) [−0.1 to 0.2]	−0.13±0.06(CDVA) [−0.2 to −0.18]	0.00
Near	0.26±0.09(UNVA) [0.1 to 0.4]	0.44±0.10(DCNVA) [0.2 to 0.6]	0.00
Intermediate (60 cm)	0.22±0.10(UIVA) [−0.1to 0.3]	0.18±0.08(DCIVA) [−0.1to 0.3]	0.18
Intermediate (80 cm)	0.16±0.11(UIVA) [−0.1to 0.4]	0.15±0.10(DCIVA) [−0.1to 0.3]	0.79
Reading speeds (wpm)
Reading speed (40 cm)	114.48 ± 6.98 [100to 127]	108.52 ± 7.63 [93 to 121]	0.006
Reading speed (60 cm)	126.44 ± 7.93 [115 to 143]	125.88 ± 7.46 [112 to 142]	0.84
Reading speed (80 cm)	123.16 ± 5.89 [111to 132]	127.28 ± 5.67 [113 to 136]	0.07
Uncorrected reading speeds40 cm v/s 60 cm			0.00
Uncorrected reading speeds40 cm v/s 80 cm			0.00
Uncorrected reading speeds60 cm v/s 80 cm			0.10

Abbreviations: UDVA, uncorrected distance visual acuity; CDVA, corrected distance visual acuity; UNVA, uncorrected near vision acuity; DCNVA, distance-corrected near visual acuity; UIVA, uncorrected intermediate visual acuity; DCIVA, distance-corrected intermediate visual acuity.

Figure 1 Percentage binocular cumulative UDVA and CDVA for the monofocal and ERV groups, 6 months post-operatively.

Figure 2 Percentage binocular uncorrected near visual acuity (UNVA), for the monofocal and ERV groups, 6 months post-operatively.

Figure 3 Percentage binocular uncorrected intermediate visual acuity (UIVA) @ 60 and 80 cm 6 months post-operatively.

Table 3 Uniocular Post-Operative Data

Parameter	Monofocal IOL(Tecnis)	ERV IOL(Symfony)	p-value
	n = 25 Eyes	n = 25 Eyes
	Mean± SD [Range]	Mean± SD [Range]
UDVA (LogMAR)	0.04±0.08 [−0.08to 0.22]	0.20±0.07 [0.02to 0.32]	0.00
CDVA (LogMAR)	−0.02±0.04 [−0.1to 0.08]	−0.01±0.03 [−0.1to 0]	0.35
Sph (D)	−0.07±0.17 [−0.5to 0.25]	−0.71±0.29 [−1.25to 0]	0.00
Cyl (D)	−0.16±0.42 [−1to 0. 5]	−0.16±0.17 [−0.5to 0]	0.69
SE (D)	−0.10±0.25 [−0.5to 0]	−0.79±0.31 [−1.5to 0]	0.00
UNVA	0.47±0.18 [0.1to 0.7]	0.21±0.09 [0to 0.5]	0.00
DC NVA	0.78±0.07 [0.7to 0.9]	0.39±0.06 [0.3to 0.5]	0.00
FACT
A (1.5 cpd)	1.2 ± 0.09 [1.11to 1.4]	1.16 ± 0.09 [0.95to 1.25]	0.19
B (3 cpd)	1.55 ± 0.1 [1.3to 1.76]	1.52 ± 0.08 [1.3to 1.6]	0.18
C (6 cpd)	1.43 ± 0.08 [1.36to 1.52]	1.40 ± 0.12 [1.08to 1.52]	0.45
D (12 cpd)	1.09 ± 0.08 [0.9to 1.18]	1.05 ± 0.10 [0.9to 1.18]	0.24
E (18 cpd)	0.65 ± 0.08 [0.6to 0.78]	0.64 ± 0.07 [0.6to 0.78]	0.53

Abbreviations: UDVA, uncorrected distance visual acuity; UDVA, uncorrected distance visual acuity; D, dioptre; UNVA, uncorrected near visual acuity; DCNVA, distance corrected near visual acuity; cpd, cycles per degree.

Figure 4 Post-operative spherical equivalent (SE) predictability for the Tecnis-1 monofocal and Symfony ERV groups, 6 months post-operatively.

Figure 5 Post-operative refractive astigmatism (dioptres) for the Tecnis-1 monofocal and Symfony ERV groups, 6 months post-operatively.

Figure 6 Reading speeds with Salzburg Reading Desk, for the Tecnis-1 monofocal and Symfony ERV groups, 6 months post-operatively.

Figure 7 Binocular photopic contrast sensitivity for Tecnis-1 monofocal and Symfony ERV groups at 6 months post-operatively.

Figure 8 Defocus curves, y-axis= CDVA logMAR, x axes= level of defocus in dioptres for the Tecnis-1 monofocal and Symfony ERV groups.

Table 4 QOV Questionnaire for Dysphotopsia Symptoms Grading and Spectacle Independence

Symptom Severity	Glare Grading
Nil	Grade 1
Mild	Grade 2
Moderate	Grade 3
Severe	Grade 4
Symptom Severity	Haloes Grading
Nil	Grade 1
Mild	Grade 2
Moderate	Grade 3
Severe	Grade 4
Symptom Severity	Starbursts Grading
Nil	Nil
Mild	Mild
Moderate	Moderate
Severe	Severe
Spectacle Independence
Complete	80–100%
Partially dependent for certain activities	40–79%
Dependent on spectacles for all activities	<40%

Notes: Dysphotopsia symptoms (glare/haloes/starbursts) grading was done as per the following questionnaire: 1 = nil, no dysphotopsia symptoms experienced; 2 = mild/minimal dysphotopsia not affecting night vision and routine activities; 3 = moderate, dysphotopsia symptoms affecting night vision and routine activities, but manageable; 4 = severe, bothersome dysphotopsia, severe enough to interfere in routine activities. Spectacle independence was assessed on a scale of 0–100%.