Pseudophakic Monovision Research Articles

IRIS® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation.

To determine the incidence of pseudophakic monovision among patients bilaterally implanted with monofocal intraocular lenses (IOLs) and to characterize the distribution of myopic offsets achieved. This retrospective database study included data on patients receiving care from ophthalmologists who contributed to the Academy IRIS® (Intelligent Research In Sight) Registry. Anonymized data were collected, including patient age, ethnicity, procedure data (CPT code, date, laterality), and postoperative manifest refractive spherical equivalent (MRSE) in both eyes implanted with monofocal or monofocal toric IOLs. No data regarding IOL manufacturer, model, or power were collected. One primary outcome measure was the percentage of patients achieving monovision (defined as emmetropia within ±0.25 diopters [D] in one eye and a myopic offset of ≥0.50 D in the fellow eye) among all patients receiving bilateral monofocal IOLs at the time of cataract surgery between January 1, 2016, and September 1, 2019, with at least 90 days of follow-up. Other primary outcomes included the distribution and frequency of myopic offsets (anisometropia) between eyes. Of the 16,765 people receiving bilateral monofocal IOLs within the study period, 4796 (28.6%) achieved emmetropia in at least one eye, as defined by an MRSE within ± 0.25 D. The incidence of monovision among these patients was 34.2% (1638/4796). One-quarter (24.7%; 405/1638) of patients who achieved monovision had a myopic offset between 0.50 and 0.74 D, with more than one-third (35.2%; 576/1638) falling within 0.75-1.24 D and 18.0% within 1.25-1.74 D. A myopic offset ≥1.75 D was observed in 22.1% (362/1638) of patients who achieved monovision. Pseudophakic monovision for presbyopia correction was achieved in ~34% of patients in the IRIS Registry bilaterally implanted with monofocal IOLs, with myopic offsets typically ranging from 0.5 to 1.24 D.

Fall risk in patients with pseudophakic monovision

ObjectiveVision changes can precipitate falls in the elderly resulting in significant morbidity and mortality. We hypothesized that pseudophakic monovision and ensuing anisometropia and aniseikonia impact elderly fall risk. This study assessed fall risk in patients with pseudophakic monovision, pseudophakic single vision distance (classic cataract surgery), and cataracts with no surgery. DesignRetrospective single-institution cohort study ParticipantsPatients with bilateral cataracts diagnosed at 60 years of age or older who underwent bilateral cataract surgery (monovision or single vision distance) or did not undergo any cataract surgery (n = 13 385). Patients with unilateral surgery or a fall prior to cataract diagnosis were excluded. MethodsData were obtained from the Stanford Research Repository. Time-to-fall analysis was performed across all 3 groups. Primary outcome was hazard ratio (HR) for fall after second eye cataract surgery or after bilateral cataract diagnosis. ResultsOf 13 385 patients (241 pseudophakic monovision, 2809 pseudophakic single vision, 10 335 no surgery), 850 fell after cataract diagnosis. Pseudophakic monovision was not associated with fall risk after controlling for age, sex, and myopia. Pseudophakic single-vision patients had a decreased time to fall compared with no-surgery patients (log rank, p < 0.001). Older age at cataract diagnosis (HR =1.05, 95% confidence interval [CI] 1.04–1.06, p < 0.001) or at time of surgery (HR = 1.05, 95% CI 1.03–1.07, p < 0.001) increased fall risk, as did female sex (HR = 1.29, 95% CI 1.10–1.51, p = 0.002) and preexisting myopia (HR = 1.31, 95% CI 1.01–1.71, p = 0.046) among nonsurgical patients. ConclusionsPseudophakic monovision did not impact fall risk, but pseudophakic single vision may increase falls compared with patients without cataract surgery.

Crossed versus conventional pseudophakic monovision for high myopic eyes: a prospective, randomized pilot study

BackgroundAiming at spectacle independence, conventional pseudophakic monovision has been widely used in myopia patients with bilateral monofocal intraocular lens implantation. However, the crossed monovision, which is to correct the dominant eye for near vision and the non-dominant eye for distant vision, has been mentioned preferable for high myopic cataract patients by some studies.We have conducted this study to compare clinical results to assess the feasibility of conventional and crossed monovision for high myopic pseudophakic patients by comparing patient satisfaction, visual function and spectacle independence.MethodForty-sixth high myopia patients were divided into two groups: 22 in crossed monovision group with patients whose refraction targeted to − 2.00 diopters (D) in the dominant eye and − 0.50D in the non-dominant eye; 24 in conventional monovision group with patients whose refraction targeted to − 0.50D in the dominant eye and − 2.00D in the non-dominant eye. Binocular uncorrected distance visual acuity (BUDVA), binocular uncorrected near visual acuity (BUNVA), binocular corrected distant visual acuity (BCDVA), binocular corrected near visual acuity (BCNVA), contrast visual acuity and stereoacuity were examined at postoperative 2 weeks, 1 month and 3 months. Questionnaires were completed by patients 3 months after binocular surgery to evaluate patients’ satisfaction and spectacle independence.ResultsThe conventional monovision and the crossed monovision group showed no significant differences of mean BUDVA, BUNVA, BCDVA, BCNVA 2 weeks, 1 month or 3 months postoperatively (P > 0.05). There was no difference in the bilateral contrast sensitivity or stereoscopic function between the convention conventional and crossed monovision groups (P > 0.05). Patient satisfaction with near and distant vision, as well as spectacle dependence did not differ significantly between the two groups (P > 0.05).ConclusionCrossed pseudophakic monovision exhibited similar visual function when compared with conventional monovision technique, which indicates that it is an effective option to improve the visual functionality and quality of life for high myopic patients who considering bilateral cataract surgery.Trial registrationThe Institutional Review Board and Ethics committee of the First Affiliated Hospital of Chongqing Medical University, Chongqing, China. The trial registration was submitted in September 2018 and passed on March 18, 2020, and the registration number is: ChiCTR2000030935.

Accuracy of intraocular lens power calculation methods when targeting low myopia in monovision.

To investigate the accuracy of IOL power calculation methods for refractive targets of myopia compared with emmetropia. Lions Eye Institute, Perth, Australia. Retrospective analysis. Patients undergoing bilateral, sequential cataract surgery with a plan of modest monovision were analyzed. Target refraction was plano (distance eye) and -1.25 diopters (D) (near eye). Prediction error was determined by comparing the actual postoperative refraction with the predicted postoperative refraction, calculated by the Barrett Universal II (BUII), Hill-RBF version 2.0 (Hill-RBF 2.0), Haigis, Holladay 1, SRK/T, and Hoffer Q formulas. The dataset was divided into distance and near eye subgroups. Mean and median absolute error and percentage of eyes within ±0.25, ±0.50, ±0.75, and ±1.00 D of refractive target were compared. The study included 88 consecutive patients. There was a consistent trend for lower refractive accuracy in the near eyes. BUII and Hill-RBF 2.0 were the most accurate overall and least affected by this phenomenon, with 1 (1.1%) and 4 (4.6%) fewer eyes, respectively, in the near subgroup achieving ±0.50 D of target. Haigis and SRK/T were most affected, with 14 (15.9%) and 11 (12.5%) fewer near eyes achieving ±0.50 D of target (P < .05). Holladay 1 and Hoffer Q occupied the middle ground, with 6 (6.8%) and 9 (10.2%) fewer near eyes achieving ±0.50 D of target. IOL-power calculation formulas appear to be less accurate when targeting myopia compared with emmetropia. BUII and Hill-RBF 2.0 represented good options when planning pseudophakic monovision as they were least affected by this phenomenon and can be used for both distance and near eyes.

Disruptive Innovation and Refractive IOLs: How the Game Will Change With Adjustable IOLs.

The light-adjustable lens is the first Food and Drug Administration (FDA)-approved product from an entirely new category of intraocular lenses (IOLs). The 3-piece foldable silicone light-adjustable lens is implanted through a small incision after phacoemulsification. A slit-lamp-based digital light delivery device is used to adjust and then lock-in the IOL power during the first postoperative month. Up to 4.5 diopters (D) of cylindrical or spherical adjustment can be achieved. This should offer significant advantages in difficult IOL power calculation cases, such as postrefractive eyes. In addition to achieving better refractive accuracy, an adjustable IOL will now allow patients to test and elect a different refractive target postoperatively. This paradigm shift will change how cataract patients choose their refractive objectives, and how ophthalmologists will be able to achieve them. For example, adjustable IOLs may increase the popularity of pseudophakic monovision and bilateral same-day sequential surgery. For those electing adjustable IOL, preoperative patient counseling will change and certain pre- and intraoperative technologies, such as intraoperative aberrometry and digital astigmatic axis marking, would become superfluous.

Revisiting monovision for presbyopia.

Presbyopia is an inevitable age-related loss of accommodation that results in spectacle dependence with common everyday near-vision tasks. Many surgical approaches to presbyopic correction have been investigated, with monovision correction being amongst the most common and attractive options. In this article, we will review the advantages and disadvantages of the new modalities of presbyopic monovision correction. New methods such as mini-monovision, corneal inlays, and multifocal corneal ablation aim to maximize stereopsis and decrease the anisometropic side effects of conventional monovision. These include inlays such as the KAMRA and Raindrop, and phakic intraocular lenses such as the hole ICL. Newer corneal laser refractive procedures such as small incision lenticule extraction have also shown good outcomes with monovision. Pseudophakic monovision using standard monofocal lenses still provides good results. Monovision for presbyopic correction continues to provide promising results. There are a number of new devices and techniques that have shown good visual acuity outcomes, patient satisfaction and spectacle independence.

Monovision Versus Multifocality for Presbyopia: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Refractive surgery in presbyopia tends to achieve spectacle independence with minimal optical disturbances. We compared monovision to multifocality procedures regarding these outcomes. We conducted a systematic review of published (till November 21, 2016) randomized controlled trials (RCTs) comparing any monovision to any multifocality method or comparing different monovision/multifocality methods to each other that enabled direct or indirect comparisons between particular monovision and particular multifocality procedures in presbyopic patients undergoing cataract-related or unrelated surgery in respect to spectacle independence, unaided binocular visual acuity (VA), contrast sensitivity (CS), and adverse events. Three trials comparing monovision (monofocal lenses, LASIK) to multifocal intraocular lenses (MFIOLs; Isert refractive or Tecnis diffractive) and 6 comparing other MFIOLs to Tecnis were included (1-12months duration). Spectacle independence. All reporting trials were of sufficient quality. Directly, pseudophakic monovision was inferior to Isert (1 trial, N=75, RR=0.49, 95% CI 0.28-0.80) and Tecnis (1 trial, N=211, RR=0.36, 95% CI 0.25-0.52) in cataract patients, and LASIK was comparable to Tecnis (1 trial, N=100, RR=0.93, 0.78-1.10) in refractive surgery. In network meta-regression (6 trials, 14 arms) pseudophakic monovision in cataract patients was inferior to Tecnis. Indirect data suggest also that it is inferior (ReZoom refractive, TwinSet diffractive) or tends to be inferior (Array refractive) to other MFIOLs. LASIK was comparable to Tecnis in refractive surgery. Indirect data suggest also that it tends to superiority vs. ReZoom or Array refractive MFIOLs. Adverse events. No pooling was possible (heterogeneity of assessment and reporting). One quality direct RCT indicated less glare/dazzle with pseudophakic monovision vs. Tecnis in cataract patients. Unaided VA and CS data were burdened with heterogeneity (assessment, reporting) and insufficient quality. Randomized comparisons of monovision to multifocality are scarce. Existing estimates regarding spectacle independence (imprecision, indirectness) and particularly regarding unaided VA and CS (assessment/reporting heterogeneity, bias, imprecision, indirectness) are burdened with uncertainty. Dysphotopsia is less common with monovision, but estimate uncertainty is high (bias, imprecision).

A systematic review of pseudophakic monovision for presbyopia correction

A systematic review of the recent literature regarding pseudophakic monovision as a reliable methods for presbyopia correction was performed based on the PubMed, MEDLINE, Nature and the American Academy of Ophthalmology databases in July 2015 and data from 18 descriptive and 12 comparative studies were included in this narrative review. Pseudophakic monosvision seems to be an effective method for presbyopia with high rates of spectacles independence and minimal dysphotopsia side-effects, that should be considered by the modern cataract surgeons.

Etiology and outcomes of secondary surgical intervention for dissatisfied patients after pseudophakic monovision.

To evaluate the etiology and the clinical outcomes of secondary surgical interventions for dissatisfied patients after pseudophakic monovision. Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan. Retrospective case series. This study comprised 12 eyes in 12 patients (age 66.2±5.6years) who underwent photorefractive keratectomy (PRK) enhancement to improve their dissatisfaction after pseudophakic monovision. We quantitatively assessed the visual and refractive outcomes and the subjective satisfaction measured using a visual analog scale, that ranged from 0 (very dissatisfied) to 10 (very satisfied), before and 3months after PRK enhancement. Six (50%) of the 12 patients were dissatisfied with their various distance visions because of a large amount of anisometropia (≥2.50D). Two (16.7%) were dissatisfied with their distance vision after conventional monovision because of residual cylindrical errors (≥0.75D) in the dominant eye. Three (25%) was an unknown origin. The remaining one of the 12 patients was dissatisfied due to the unadaptability to crossed monovision. Eleven (91.7%) eyes were within ±0.5D of the targeted correction after PRK enhancement. The overall satisfaction score was significantly improved, from 3.7±2.4 (range 0-7) preoperatively to 6.0±2.4 (range 2-9) postoperatively (p=0.02). No vision-threatening complications were seen throughout the observation period. PRK enhancement was effective with predictable refractive results and thus improved patient satisfaction for dissatisfied patients after pseudophakic monovision. These findings also suggest that the accurate correction of refractive errors plays a key role in successful pseudophakic monovision.

Evaluation of activities of daily living following pseudophakic presbyopic correction

BackgroundPseudophakic presbyopic correction is among the prevalent methods for regaining near vision capacity. The purpose of this study is to compare the impact of pseudophakic monovision correction and multifocal lens implantation on the performance in a series of activities of daily living (ADL) of presbyopic patients.MethodsAn ADL research framework (10 ADLs) was constructed and validated in a sample of patients divided into three validation groups according to their near visual acuity. Sixty-two participants that underwent mini-monovision (MoG) cataract extraction and 60 that underwent bilateral multifocal lenses implantation (MfG) populated study groups and addressed the ADLs. Binocular uncorrected distant (BdUVA) and near (BnUVA) visual acuity were associated with ADL scores and with subjective satisfaction using the VF-14 questionnaire.ResultsTest-retest reliability [all Intraclass Correlations Coefficients (ICC) >0.90] and construct validity (all p < 0.05) tests indicated sufficient psychometric performance of the ADL framework. Both study groups presented comparable mean ADL scores (p = 0.07) however, MoG patients had lower performance in demanding ADLs (p = 0.02). ADL scores demonstrated significant correlation with BnUVA (r2 = −0.67, p < 0.01) VF-14 scores (r2 = 0.53, p < 0.01).ConclusionsBoth methods provide sufficient near vision capacity for the majority of activities of daily living. However, only multifocal lens implantation can address demanding near vision tasks.Trial registrationClinicalTrials.gov Identifier: NCT02431156.

The Quest for Spectacle Independence: A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia

ABSTRACTWe performed a literature review comparing multifocal intraocular lens (IOL) implantation with pseudophakic monovision to treat presbyopia. Multifocal IOLs utilize refractive or diffractive principles to treat both distance and near vision, with a single lens implant. Monovision uses traditional monofocal lens implants to treat the dominant eye for emmotropia, and the non-dominant eye for myopia. This planned anisometropia is designed to enhance intermediate or near vision. Generally, distance vision was similar with both types of lens implantation, near vision was better with multifocal IOLs, and intermediate vision appeared to be better in the monovision group. For patients requiring cataract surgery, both multifocal IOLs and monovision appear to address presbyopia with a high level of patient satisfaction. More patients reported complete spectacle independence with multifocal IOLs, but more glare and halos were reported by multifocal IOL patients as well.

Clinical Results of Pseudophakic Monovision 1 Year after Cataract Surgery

Clinical Results of Pseudophakic Monovision 1 Year after Cataract Surgery

Crossed versus conventional pseudophakic monovision: Patient satisfaction, visual function, and spectacle independence

To compare patient satisfaction, visual function, and spectacle independence in patients with crossed or conventional pseudophakic monovision. Department of Ophthalmology, Henry Ford Health System, Taylor, Michigan, USA. Retrospective comparative cohort study. Cataract surgery patient records from June 1999 to December 2013 were reviewed. Crossed monovision patients were identified. Control conventional monovision cases were matched for age, sex, general health, personal lifestyle/main hobbies, preoperative refractive status, postoperative refractive status, uncorrected distance visual acuity, uncorrected near visual acuity, astigmatism level, and anisometropia level. A survey was mailed to participants, and results were independently analyzed. The review comprised 7311 patient records. Forty-four crossed monovision patients were identified, and 30 of them were enrolled. Thirty matched pairs were surveyed. The mean anisometropia was 1.19 diopters (D) in the conventional and 1.12 D in the crossed monovision groups. No significant difference was identified for eye-hand coordination, eye-foot coordination, or sport-related depth perception, but satisfaction was slightly better in the crossed monovision group (P = .028). No significant difference was identified for 6 of 8 spectacle independence measures, but nighttime driving was a little easier for the crossed monovision group (P = .025). Seventy-seven percent of crossed and 50% of conventional monovision patients did not use glasses for intermediate distance activities (P = .037). Crossed pseudophakic monovision appears to work as well as conventional pseudophakic monovision in terms of patient satisfaction and spectacle independence in patients with a mild degree of anisometropic pseudophakia. No author has a financial or proprietary interest in any material or method mentioned.

Effect of pseudophacic mini-monovision as an option for independence of spectacles in everyday life

Modern day patients who undergo bilateral cataract surgery expect to be spectacles-independent after surgery. The options that are available to attain this goal are pseudophakic monovision, implanting multifocal IOLs or alternatively accommodative IOLs. The aim of this study is to establish the suitability in daily life when attaining minor monovision, named hereafter mini-monovision. In this clinical retrospective study 30 patients were examined. These subjects where bilaterally pseudophake and received either AcrySof®-IOL or Acreos® Adapt-IOL with a slight anisometropia of between 0.5 and 1.75 D and with a maximal astigmatism up to 1.5 D. Visual acuity (VA) for distance (ETDRS), intermediate (Jaeger 80 cm) and near (Jaeger 40 cm) as well as defocus curves were assessed. Furthermore were examined: the reading speed using the font size of the Radner reading chart, anisoconia (FA Oculus according to Esser), stereopsis (Titmus), subjective patient satisfaction (adapted VF-14-questionnaire) and the subjective dependence on having to wear spectacles. The median anisometropia was at 0.75 D; the age was between 61 and 80 (median being at 73 years). 12 patients were male and 18 female. When examined with binocular vision 100 % could attain distance VA of at least decimal 1.0 (LogMAR 0) and an intermediate VA of at least decimal 0.8 (LogMAR 0.1), up to 86.57 % a near VA of at least Jaeger 5, (LogMAR 0.4); up to 63.33 % even managed at least Jaeger 3 (LogMAR 0.3). The median average reading speed for binocular uncorrected reading under photopic conditions was 145 words/minute and under mesopic conditions 117 words/minute. The critical font size was LogRAD 0.60 (Jaeger 5-6), the anisoconia at 2 % and stereopsis at 80 arc seconds. The general dependence on glasses was reduced from 100 % preoperatively to 13 %, postoperatively. Simultaneously a high patient satisfaction score of 93.18 in the VF-14 questionnaire was attained. The result is comparable to those quoted in the literature on full monovision and mulitifocal IOLs. To attain spectacles independency, pseudophake mini-monovision is a cost efficient alternative to multifocal lenses for well selected patients. A relative reduction in near VA must be taken into account. To establish the refractive target further examinations are required. Establishing the accurate depth of vision will be helpful in attaining this.

Binocular Visual Function of Modified Pseudophakic Monovision

To compare binocular visual function of pseudophakic patients having modified monovision (0.75 diopter [D] anisometropia) with that of patients having conventional monovision (1.75 D anisometropia). Prospective observational study. Eighty-two patients that underwent bilateral implantation of a monofocal intraocular lens were recruited at 3 months postoperatively. Modified monovision was simulated by adding a +0.75 D spherical lens to the nondominant eye, while conventional monovision was simulated by adding a +1.75 D spherical lens. Binocular corrected visual acuity (VA) at various distances, binocular contrast VA (contrast VA) and that with glare (glare VA), and stereoacuity were evaluated. With modified monovision, mean binocular corrected intermediate VA at 1.0 m was 20/19 and near VA at 0.3 m was 20/51, and stereoacuity was 125 ± 100 seconds of arc. Mean binocular intermediate VA at 1.0 m was significantly better with modified monovision than with conventional monovision (P = .0001), while near VA and intermediate VA at 0.5 m were significantly worse (P < .0001). Mean binocular photopic and mesopic contrast VA and glare VA tended to be better with modified monovision than with conventional monovision, but the difference was not significant. Mean stereoacuity was significantly better with modified monovision than with conventional monovision (P = .0020). Modified pseudophakic monovision provided excellent binocular VA from far to intermediate distances, although near VA was worse than that with conventional monovision. Contrast VA with and without glare tended to be better and stereoacuity was significantly better with modified monovision, suggesting that this method is useful for correcting presbyopia without marked impairment of binocular function.

Binocular function in patients with pseudophakic monovision

To evaluate the relationship between ocular deviation and stereopsis and fusion in patients who had pseudophakic monovision surgery. Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan. Retrospective comparative case series. Patients had surgical monovision correction with monofocal intraocular lens placement followed by routine postoperative examinations. The alternate prism cover test was used to measure motor alignment. Sensory tests for binocularity included sensory fusion determinations using the Worth 4-dot test, near stereopsis test, and fusion amplitude measured with a prism bar. Patients with monovision were categorized as having small-angle exophoria (≤10.0 prism diopters [Δ]) or moderate-angle exophoria (>10.0 Δ). This study comprised 60 patients with a mean age of 70.2 years ± 7.7 (SD). The difference in the mean stereopsis values between patients with small-angle exophoria and patients with moderate-angle exophoria was statistically significant (P<.001). In the moderate-angle exophoria group, 10 patients (62.5%) developed intermittent exotropia after surgery; however, no serious ocular deviation problems were observed. The fusion amplitudes in patients with pseudophakic monovision were approximately similar to normal values. Patients with moderate-angle exophoria were more likely to fail the Worth 4-dot test than those with small-angle exophoria. In patients with pseudophakic monovision having a near exophoria angle of more than 10.0 Δ, the possibility of changes in ocular deviation and stereopsis after surgery is a concern. Moreover, the application of monovision in patients with a previous moderate-angle exophoria should be carefully considered. No author has a financial or proprietary interest in any material or method mentioned.

Target refractions in bilateral monofocal pseudophakia: analysis of a mathematical model

A recent paper proposes a model for suitable target refractions for monofocal pseudophakic monovision. The purpose of this paper is to examine the mathematics that underpins the theory. The expressions for the optimal target refractions presented before are shown formally to define the minimum of the mean binocular refractive error over a range of object distances. The model is shown to be much more sensitive to errors in the distal target refraction than to errors in the proximal refraction. It is also more sensitive to the choice of proximal limit of the object range than to the distal limit. These considerations are important in selecting and evaluating suitable combinations of refractions in pseudophakic monovision. (S Afr Optom 2013 72(3) 103-109)

Five-year clinical study of patients with pseudophakic monovision

To assess the long-term clinical outcomes and acceptability of pseudophakic monovision. Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan. Case series. Patients who had surgery using the monovision method with monofocal intraocular lenses had routine postoperative examinations. Assessed were visual acuity, near stereopsis, ocular deviation, patient satisfaction, and the rate of spectacle dependence preoperatively and 1, 3, and 6 months and 1, 2, 3, 4, and 5 years postoperatively. The study enrolled 54 patients with a mean age of 74.7 years ± 7.9 (SD). The mean difference in the spherical equivalent refractive error between eyes of each patient was 2.13 diopters. The binocular uncorrected distance visual acuity was at least 0.10 logMAR in 98% of patients, with 76% achieving Jaeger 2 or better binocular uncorrected near visual acuity. Near stereopsis in patients who shifted from exophoria to intermittent exotropia decreased, although no serious problems were observed. The rate of spectacle dependence was 88% preoperatively, 41% at 1 year, and 22% at 5 years. Patient satisfaction improved gradually during the follow-up. Pseudophakic monovision was an effective approach for correcting presbyopia throughout the 5-year observation period; however, a longer follow-up, including further studies is necessary to allow selection of appropriate patients. No author has a financial or proprietary interest in any material or method mentioned.

Intentional extreme anisometropic pseudophakic monovision: New approach to the cataract patient with longstanding diplopia

To determine whether extreme pseudophakic monovision can reduce or eliminate diplopia in patients with cataract and longstanding acquired strabismus. Department of Ophthalmology, University of Cincinnati, and the Cincinnati Eye Institute, Cincinnati, Ohio, USA. Case series. Intentional extreme monovision was created in patients with stable diplopia having cataract surgery. Intraocular lens selection was targeted for emmetropia in 1 eye and at least 3.0 diopters of myopia in the fellow eye. Twelve patients with stable diplopia attained excellent uncorrected distance and near vision with a marked reduction in or elimination of double vision. Patients with stable acquired strabismus with diplopia may be candidates for extreme pseudophakic monovision, which may be a new strategy to eliminate double vision. No author has a financial or proprietary interest in any material or method mentioned.

Visual Function and Patient Satisfaction in Pseudophakic Monovision

Visual Function and Patient Satisfaction in Pseudophakic Monovision