Visual Outcomes Comparing Emmetropia Versus Mini-Monovision After Bilateral Implantation Of An Extended Vision Iol : Randomized Trial

Purpose: To compare visual outcomes and patient satisfaction following bilateral implantation of a non-diffractive extended vision intraocular lens (IOL) when targeting emmetropia versus mini-monovision

Raghudeep Eye Hospital, Ahmedabad, India

Methods: Prospective, randomized controlled trial in 70 patients(140 eyes)undergoing bilateral cataract surgery with non-apodized, extended vision IOLrandomized to:group I(n=35 pts)IOL implantation with emmetropic target in both eyes,or group II(n=35 pts)IOL implantation with mini monovision. Following were evaluated binocularly 1and 6 months following second eye surgery:unaided and corrected near visual acuity at 40 centimetres,unaided and corrected distance and intermediate visual acuity at 66cm were evaluated. Mesopic contrast sensitivity,binocular defocus curve and patient satisfaction were also assessed 6 mths postoperatively.

Result: 34 and 33 patients in groups I and II completed followup. Binocular unaided near visual acuity was significantly better in group II(0.26+0.05 vs 0.22+0.08 LogMAR,P=0.03). Reading add required for minimonovision was significantly lower than that with emmetropia. Unaided intermediate visual acuity(0.09+0.06 vs 0.07+0.08 LogMAR) and distance vision was not significantly different between groups (0.02+0.04 vs 0.02+0.05 LogMAR,P=0.78). Mesopic contrast sensitivity with and without glare was not significantly different between the groups. No patient in any group had bothersome glare,haloes.

Conclusion: Binocular unaided near visual acuity was significantly better with excellent distance visual acuity when targeting mini monovision of -0.5 diopters with the non-diffractive extended vision IOL during cataract surgery. Surgeons may consider this strategy