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Pseudophakic monovision: optimal distribution of refractions

Session Details

Session Title: New evaluation tools in refractive surgery

Session Date/Time: Sunday 06/10/2013 | 08:00-09:30

Paper Time: 08:39

Venue: Forum (Ground Floor)

First Author: : K.Nęser DENMARK

Co Author(s): :    J. Hjortdal   W. Harris           

Abstract Details


To determine the optimal distribution of refractions in monofocal, pseudophakic monovision.


Department of Ophthalmology, Randers Regional Hospital, Denmark


A previously reported mathematical method for describing defocus for a single eye (Acta Ophthalmol (2011), 89: 111-115) is expanded to the binocular situation. The binocular distribution of refractions yielding the least defocus over the most extended fixation intervals is identified by mathematical optimization. The results are tested in a group of 22 pseudophakic patients.


For the fixation interval 0.25 m to 6.0 m the optimal refractions are pure spheres of -0.27 D for the distance eye and -1.15 D for near eye. The mathematically derived defocus structure is confirmed in the clinical series.


The reported mathematical method enables identification of the optimal distribution of refractions over any fixation interval. Monovision with refractions of approximately -0.25 D and -1.25 D may lead to spectacle independence for distance and intermediate vision. Binocular problems - such as monovision suppression, reduced stereoacuity, and binocular inhibition – are likely to be minimal with the suggested anisometropia of 1.0 D. This moderate monovision is fully reversible with spectacle correction, as the induced aniseikonia is minimal and it therefore represents a safe alternative to multifocal IOLs.

Financial Interest:


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