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

Authors Abdelrazek Hafez T, Helaly HA

Received 10 May 2019

Accepted for publication 30 September 2019

Published 31 October 2019 Volume 2019:13 Pages 2111—2117


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Tarek Abdelrazek Hafez, Hany Ahmed Helaly

Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

Correspondence: Hany Ahmed Helaly
Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdy Street, Roshdy, Alexandria, Egypt
Tel +201225466733

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

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