Outcomes on pseudophakic mini-monovision with monofocal intraocular lens on intermediate vision with immediate...

To evaluate visual, refractive and patient-reported outcomes of a mini-monovision strategy using the Clareon® (Alcon Laboratories, Fort Worth, Texas, USA) monofocal intraocular lens (IOL) for intermediate vision following immediate sequential bilateral cataract surgery (ISBCS).

In this prospective study, twenty-seven patients (54 eyes) underwent ISBCS with Clareon® monofocal IOL implantation, targeting emmetropia in the dominant eye and -0.75 D myopic offset in the non-dominant eye. The primary outcome was binocular uncorrected intermediate visual acuity (UCIVA) at 66 cm at 1 and 3 months. Secondary outcomes included monocular UCIVA, binocular uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity (BCDVA). Tertiary outcomes were binocular defocus curve, reading speed (Salzburg Reading Desk) and Catquest-9SF questionnaire.

Mean participant age was 73.5 years (range 53-91), with 59% female. Binocular UCIVA was 0.11 ± 0.14 and 0.10 ± 0.12 LogMAR ( ± SD) at 1 and 3 months, respectively. Monocular UCIVA (non-dominant eye) was 0.14 ± 0.16 and 0.11 ± 0.13 LogMAR. Binocular UCDVA was -0.01 ± 0.10 and -0.02 ± 0.10 LogMAR at 1 and 3 months. Binocular BCDVA was -0.07 ± 0.10 and -0.07 ± 0.07 LogMAR. Reading speed improved from 99 ± 32 to 103 ± 39 words per minute. Defocus curves demonstrated visual acuity of 0.1 LogMAR or better from -1.50 D to +0.50 D. Refractive outcomes were stable with a mean spherical equivalent of +0.08 ± 0.30D (dominant eye) and -0.66 ± 0.25D (non-dominant eye) at three months. Catquest-9SF Rasch scores improved from 0.28 ± 1.62 preoperatively to 2.48 ± 1.10 at 1 month and 2.62 ± 1.24 at 3 months (both p < 0.01).

Mini-monovision with Clareon® monofocal IOLs and ISBCS provides good binocular uncorrected intermediate vision with high patient satisfaction.