Comparison Of Contrast Sensitivity And Visual Acuity In Patients Bilaterally Implanted With An Enhanced Monofocal Iol: Binocular Emmetropic Target Versus Modest Monovision
Published 2024 - 42nd Congress of the ESCRS
Reference: FP01.11 | Type: Free paper | DOI: 10.82333/6p2t-rj66
Authors: Bartlomiej Markuszewski* 1 , Adam Wylegala 2 , Anna Markuszewska 3 , Ewa Wróblewska-Czajka 4 , Magdalena Nandzik 4 , Dominika Szkodny 5 , Klaudyna Szydełko 3 , Edward Wylegala 4
1Wroclaw Eye Center,Wroclaw,Poland;Department of Ophthalmology, Faculty of Medical Sciences,Medical University of Silesia,Katowice,Poland, 2Department of Pathophysiology,Medical University of Silesia,Katowice,Poland;Department of Ophthalmology,District Railway Hospital ,Katowice,Poland, 3Wroclaw Eye Center,Wroclaw,Poland, 4Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences,Medical University of Silesia,Katowice,Poland, 5Department of Ophthalmology,Medical University of Silesia,Katowice,Poland
Purpose
The purpose of this study was to investigate contrast sensitivity and visual acuity outcomes of cataract patients bilaterally implanted with RayOne EMV RAO200E (Rayner) intraocular lenses (IOLs) and to compare outcomes of subjects targeted for bilateral emmetropia (Group E) versus patients for whom a monovision approach was pursued (Group M).
Setting
The setting in private outpatient surgical ophthalmology center in Wroclaw, Poland.
Methods
This prospective, singlecenter study included 88 eyes of 44 patients. 28 patients (74.1±8.4 years) were targeted for emmetropia (Group E) and 16 subjects (72.9±5.5 years) were treated using a modest monovision approach with a target refraction of -1.0 D in the non-dominant eye (Group M). Exclusion criteria were corneal astigmatism >1.0 D, corneal, retinal or optic nerve pathologies or previous eye surgery. Follow-up exams, performed at 1 day, 2 weeks, and 1 month (1M), included binocular contrast sensitivity (CS) between 1.5 and 18 cycles per degree (cpd) under photopic and mesopic light conditions using the Frey CP-400 device as well as uncorrected distance, intermediate (66cm) and near (40cm) visual acuity (UDVA, UIVA, and UNVA).
Results
At 1M, mean CS outcomes were well within the normal band of this age group. The CS outcomes in Group E were slightly (but statistically not significantly) higher. For 1.5, 3, 6, 12, and 18 cpd, mean photopic logCS in Group E (Group M) was 1.67±0.18 (1.62±0.23), 1.91±0.26 (1.90±0.21), 1.87±0.30 (1.90±0.27), 1.52±0.41 (1.40±0.32), and 1.12±0.38 (0.98±0.26), respectively. Under mesopic conditions, the outcomes were: 1.80±0.28 (1.74±0.25), 1.96±0.26 (1.93±0.24), 1.84±0.32 (1.82±0.25), 1.42±0.46 (1.33±0.34), and 1.05±0.36 (0.94±0.25). Mean logMAR binocular UDVA was 0.04±0.08 (E) and 0.03±0.04 (M). Binocular UIVA and UNVA of ≤2 Jaeger was achieved in 46% and 29% of subjects in Group E, and 88% and 75% of patients in Group M, respectively.
Conclusions
The monovision approach showed advantages on uncorrected vision for intermediate and near distances with no statistically significant differences for binocular distance visual acuity and contrast sensitivity outcomes between the emmetropic and the monovision group. In our opinion, bilateral implantation of RayOne EMV IOLs using a modest monovision approach seems to be a good option for cataract patients expecting a high quality of vision combined with a good distance, intermediate and a functional near vision.