The Influence Of The Level Of Monovision Upon Early Objective And Subjective Outcomes Following Bilateral Implantation Of A New Enhanced Monovision Intraocular Lens

To outline the impact of different levels of monovision upon early objective visual outcomes and quality of vision (QoV) following bilateral implantation of a new enhanced monovision intraocular lens (IOL).

Cathedral Eye Clinic, Belfast, Northern Ireland, UK.

The study recruited 58 consecutive patients implanted bilaterally with the Rayone EMV RAO200E IOL (Rayner). The dominant eye was targeted for distance vision with a myopic aim in the nondominant eye. Patients were categorized into 2 groups based upon the postoperative refractive outcome in the nondominant eye. Group A: -0.50 to -1.0 D (n=35), Group B: > -1.00 D (SE range: -1.125 to -1.625) (n=23). Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, and QoV were compared between the groups 3 months postoperatively.

The mean binocular UDVA was -0.05 ± 0.08 in group A and -0.07 ± 0.01 logMAR in group B. Mean binocular UIVA was 0.17 ± 0.11 and 0.12 ± 0.14 logMAR and mean binocular UNVA was 0.22 ± 0.08 and 0.13 ± 0.08 in the two respective groups. Group B shows statistically better binocular UNVA (P<0.01). High QoV scores were reported at 9.06 ± 0.68 for day and 8.23 ± 1.09 for night in group A and 8.87 ± 1.09 for day and 7.96 ± 1.64 for night in group B. There was no significant difference in overall QoV and dysphotopsias between groups. Group A had a significantly lower complete spectacle independence rate of 57.1% compared to 87% in Group B (P=0.015).

This new enhanced monovision IOL provides a satisfactory range of vision with minimal visual side effects and high postoperative QoV scores. A postoperative refractive error of -1.0D or more in the nondominant eye significantly improves binocular UNVA and spectacle independence rates, and does not appear to negatively impact overall QoV.