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Comparison of conventional and crossed monovision in pseudophakic monovision
Session Title: Multifocal IOL results
Session Date/Time: Sunday 06/10/2013 | 14:30-16:00
Paper Time: 15:51
Venue: Forum (Ground Floor)
First Author: : J.Kang SOUTH KOREA
Co Author(s): : K. Shin
To compare the clinical results of conventional monovision, which corrects dominant eye for distance vision and non-dominant eye for near vision, and crossed monovision which is the opposite method to conventional monovision in patients with pseudophakic monovision to correct postoperative presbyopia.
Konkuk University Medical Center, Republic of Korea, Department of Ophthalmology
Prospectively, phacoemulsification and monofocal IOL implantation were performed in total 59 patients from February 2010 to August 2012. Dominant eye was determined by Hole-in-card test, preoperatively. We performed surgery first on the eye with more severe cataract for distance vision and the other eye for near vision 2 to 4 weeks later. The patients were divided into conventional (N= 30) and crossed (N=29 ) monovision group after cataract surgery on both eyes.
We compared the postoperative uncorrected near visual acuity (UCNVA), uncorrected distance visual acuity (UCDVA), refractive error, stereopsis, satisfaction for far and near vision, and spectacle dependency between two groups 2 months after surgery.
Average postoperative UCNVA (logMAR) and UCDVA (logMAR) were 0.183, 0.040 in conventional monovision group, and 0.212, 0.065 in crossed monovision group. Average postoperative spherical equivalent for far and near were -0.108 diopter (D), -1.375D in conventional monovision group, and -0.013D, -1.306D in crossed monovision group. There were no significant differences between two groups.
Overall satisfaction rates were 83.3% (distance vision) and 80% (near vision) in conventional, and 93.1% (distance vision) and 79.3% (near vision) in crossed monovision group.
Average postoperative stereopsis (254 seconds of arc in conventional, and 235 seconds of arc in crossed monovision group) and postoperative spectacle dependency (30% (distance glass), 50% (near glass) in conventional, and 27.6% (distance glass), 27.6% (near glass) in crossed monovision group) showed no differences between two groups.
Pseudophakic monovision is a very effective method for correcting postoperative presbyopia in cataract surgery. Most of cataract specialists usually correct dominant eye for disctance vision in pseudophakic monovision. In our study, crossed monovision had as good results as conventional monovision. Therefore, eye dominance is not so important in pseudophakic monovision, if there is 2 to 4 weeks of adaptation period after first eye operation.