Evaluation Of The Visual Performance Of Clareon Iol In Patients With Bilateral Implantation Targeted For Micro Monovision

With increasing patient expectations after cataract surgery, the search for a lens profile which gives good quality and dysphotopsia free vision is the need of the hour. The advanced monofocal lenses seem to fit the role well. An average person requires more of distance and intermediate vision rather than near vision throughout their day. Providing a blended vision with a mini monovision concept has been tried successfully in the past.

We wished to assess visual outcomes after bilateral implantation of a new hydrophobic acrylic aspheric IOL in patients with planned mini monovision, in particular for the intermediate range of distance.

This is an investigator initiated study conducted at Laxmi Eye Institute, Panvel, India (Tertiary Care Centre). It is an ongoing study. The sample size of the study is 45 patients, who have been bilaterally implanted with a hydrophobic acrylic aspheric IOL, targetting mini monovision.

This is an investigator initiated, prospective, single-center longitudinal study of 45 patients who underwent bilateral cataract surgery using mini monovision. The patients were implanted with the Clareon IOL (model SY60CL; Alcon Vision LLC) binocularly keeping the dominant eye emmetropic (0D) and the non dominant eye slightly myopic (-0.5D). Patients with preoperative astigmatism of > 0.75 D, and postoperative manifest refraction > +/-0.25 D in the dominant eye and > +/-0.75 D in the non-dominant eye were excluded. The main outcomes measured were binocular uncorrected, corrected visual acuities at distance, intermediate, near at 1 mth & 3 mths, binocular defocus curve and patient-reported spectacle use(PRISQ) at 3mths postoperatively.

This is a currently ongoing study. Interim results of 13 patients show the median binocular uncorrected distance visual acuity (UDVA) was 0.00 logMAR (IQR: 0.00 to 0.10 logMAR). Median uncorrected intermediate visual acuity (UIVA) was 0.20 logMAR and uncorrected near visual acuity (UNVA) was 0.30 logMAR (both IQR: 0.20 to 0.40 logMAR). The defocus curve showed a smooth and wide profile toward the myopic range, especially within the intermediate defocus range (near -1.50 D defocus, corresponding to 66 cm). 71.4% of patients did not need glasses after surgery for distance and intermediate vision at 3mths. 42.9% patients did not need glasses for near vision as well.

Bilateral implantation of Clareon IOL using the mini monovision concept seems to provide good intermediate VA while maintaining distance visual acuity.