Ocular dominance and patient satisfaction after monovision induced by intraocular lens implantation

To elucidate the relationship between ocular dominance and patient satisfaction with monovision induced by intraocular lens implantation.

Eye Clinic, Kitasato University School of Medicine Hospital, Sagamihara, Kanagawa, Japan.

The durations of exclusive visibility of dominant- and nondominant-eye targets were measured in 16 patients with successful monovision and 4 patients with unsuccessful monovision to determine the characteristics of ocular dominance. The dominant eye was determined using the hole-in-card test (sighting dominance). The contrast of target in nondominant eye was fixed at 100%; the contrast of target in the dominant eye varied (ie, 100% to 80% to 60% to 40% to 20%) using rectangular gratings of 2 cycles per degree that were 4 degrees in size.

In the successful monovision group, the reversal thresholds (ie, exclusive visibility of the nondominant eye crosses over that of the dominant eye) were displayed only at low decreasing contrast (80% and 60%). However, in the unsuccessful monovision group, the reversal thresholds were at high decreasing contrast (20%) or not at all. The reversal thresholds in patients with unsuccessful monovision were at a significantly lower contrast than in patients with successful monovision (P<.05).

Success and patient satisfaction in monovision patients were significantly influenced by the magnitude of ocular dominance. The balance technique seems to be a good method to evaluate the quantity of ocular dominance and prospectively evaluate the monovision technique.