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Updated: Dec 25, 2025
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Comparison of visual performance and satisfaction with a bilateral emmetropic vs a bilateral mild myopic target using
Paolo Vinciguerra1, Jack T Holladay, Luca Pagano
1From Humanitas Clinical and Research Center (P. Vinciguerra, Pagano, Gramigna, Borgia, Lanni, Legrottaglie), Department of Biomedical Sciences, Humanitas University (P. Vinciguerra), Rozzano, Humanitas San Pio X Hospital (R. Vinciguerra), Milan, Italy; Department of Ophthalmology, Baylor College of Medicine (Holladay), Houston, Texas; USA.
Purpose:
To compare the binocular visual outcomes and satisfaction of patients with emmetropia or mild myopia (-0.50 diopters [D]) implanted with a bilateral spherical monofocal IOL.
Setting:
Ophthalmology Department, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
Design:
Prospective nonrandomized study.
Methods:
This study comprised 2 groups of 30 patients each. Group 1 included patients implanted with bilateral monofocal IOLs with near emmetropic target (plano to -0.25 D). Group 2 included patients with a postoperative bilateral target of -0.50 D. Both groups underwent uncorrected and corrected distance defocus curves postoperatively and subjective questionnaires were used to investigate patient satisfaction postoperatively.
Results:
The defocus curve showed a significant difference between Group 1 and Group 2 binocular vision (all P values <.01 except at -3.00 D where P value = .32) with Group 1 seeing significantly better than Group 2 at +1.00, +0.50, and 0 but significantly worse in all other points of the defocus. In addition, patients of Group 2 at 0 D of defocus curve (infinite) had a visual acuity close to 0 logarithm of the minimum angle of resolution (logMAR) (0.03 ± 0.04). The main outcome of Group 2 defocus curves was that, at defocus point 0 D, even if the mean refraction was -0.67 0.15 × 160, mean uncorrected logMAR visual acuity was 0.0 ± 0.06.
Conclusions:
Bilateral monofocal IOLs implanted with mild myopic target provided better intermediate visual acuity compared with emmetropia at a minimal cost in terms of uncorrected distance visual acuity.
