Visual Outcomes and Patient Satisfaction with Extended Monovision-An Innovative Strategy to Achieve Spectacle...

Area of Science:

• Ophthalmology
• Refractive Surgery

Background:

• Spectacle independence is a primary goal in refractive lens exchange (RLE), particularly for younger patients with high expectations.
• This study investigates a novel extended monovision strategy using a monofocal intraocular lens (IOL) in the dominant eye and an extended-depth-of-focus (EDOF) IOL in the non-dominant eye.
• The aim is to enhance full-range visual performance while reducing photic phenomena.

Purpose of the Study:

• To evaluate the visual outcomes and spectacle independence of an extended monovision approach in patients undergoing refractive lens exchange (RLE).

Main Methods:

• A retrospective cohort study involving 38 presbyopic patients undergoing bilateral RLE.
• Patients received a monofocal aspheric IOL in the dominant eye and a rotationally asymmetric bifocal EDOF IOL in the non-dominant eye.
• Visual acuity (distance, intermediate, near), binocular defocus curves, contrast sensitivity, stereoacuity, photic phenomena, spectacle independence, and patient satisfaction were assessed.

Main Results:

• Mean postoperative binocular uncorrected visual acuities were excellent at distance (-0.03 logMAR), intermediate (-0.08 logMAR), and near (0.04 logMAR).
• Functional vision extended across a wide range of defocus (-3.25 D to +1.00 D), with 84% of patients achieving complete spectacle independence.
• Contrast sensitivity remained within normal limits, stereoacuity was preserved in 97%, and photic phenomena were minimal.

Conclusions:

• The novel extended monovision approach combining monofocal and EDOF IOLs offers excellent uncorrected vision across all distances.
• This strategy provides high spectacle independence and minimal adverse visual effects, making it a viable alternative to multifocal IOLs for RLE candidates.