The Impact Of Modest Monovision Upon Visual Acuity And Contrast Sensitivity After Bilateral Cataract Surgery With An Enhanced Monofocal Iol Optimized For 1D Of Monovision Offset

Purpose of the study was to show differences between postoperative results after bilateral cataract surgery with implantation of RayOne EMV IOL (RAO200E, Rayner), either targeted for emmetropia (Group A) in both eyes or for modest monovision with max. 1.0 D difference between dominant and non-dominant eye (Group B).

District Health Care Facility Complex in Będzin, Ophthalmology Ward

WSB University, Dąbrowa Górnicza, Poland

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In Group A - 30 patients targeted for emmetropia in both eyes and Group B - 30 patients targeted for emmetropia in the dominant eye and for -1.0D in the non-dominant eye. The IOL power was calculated with the IOLMaster 500 biometer. Examinations included monocular and/or binocular preop CDVA and postop UDVA, UIVA, UNVA, distance, contrast sensitivity with Pelli-Robson chart, stereopsis test and comfort of vision (questionnaire). The follow-up examinations were performed at 1 day, 2 weeks, 2 and 6 months after surgery. Stereopsis examination and satisfactory questionnaire is planned at the end of the examination period. Exclusion criteria were corneal astigmatism >0.75D, corneal, retinal or optic nerve pathologies, and previous eye surgery.

Preliminary results included 10 patients at 2 weeks postoperatively. In Group A mean monocular and binocular UDVA were 0.05±0.09 and 0.05±0.10 logMAR and in Group B mean monocular and binocular UDVA were 0.13±0.25 and 0.00±0.00 logMAR, respectively. Mean binocular UIVA at Group A was 0.62±0.04 logMAR and at Group B 0.51±0.14 logMAR, respectively. Mean binocular UNVA at the Group A was 0.62±0.08 logMAR and at Group B 0.55±0.13 logMAR, respectively. All patients score on the contrast sensitivity chart 2.00 logCS or more. Further postoperative examinations (2- and 6-months) are currently being collected and will be included to the paper.

All patients gained postoperative improvement of distance visual acuity. Patients in Group B (monovision of 1.0D) showed better results for binocular UNVA and binocular UIVA in comparison with patients in Group A (both eyes targeted for emmetropia). Binocular UDVA was similar in both groups. Comfort of vision in both groups was satisfactory. Using modest monovision seems to be a good way to increase the range of focus and visual acuity in patients undergoing cataract surgery with bilateral implantation of RayOne EMV. It seems to be the maximization of advantageous effect for patients by making it still comfortable for them additionally with a high visual quality