Clinical Results After Combining Mini-Monovision With Binocular Implantation Of A Nondiffractive Monofocal Intraocular Lens With Extended Depth Of Focus

Providing results to assess the deviation of aimed and achieved refraction and the visual acuity (VA) when treating cataract with a combination of mini-monovision and implanting a nondiffractive monofocal intraocular lens (IOL) (RayOne enhanced monovision (EMV)).

Surgery and all pre and post operative examinations were conducted at the same outpatient clinic in Zurich in the period from January 2022 to January 2024. All patients were examined by two surgeons (SM and SK) prior to surgery. All postoperative data were evaluated by an ophthalmologist (MA) at the outpatient clinic in Zurich. 

A retrospective case series was conducted by analyzing 143 patients (286 eyes) who had bilateral implantation  of an EMV IOL after cataract surgery targeting for mini monovision. Data collected included biometry, spherical equivalent (SA), best corrected visual acuity (BCVA) in distance, uncorrected visual acuity (UCVA) in near and distance and spectacle independency. Patients were seen at day 1, 1 week and 6 weeks after cataract surgery. The binocular UCVA was measured after 6 weeks. Patients with eye pathologies other than cataract were excluded from this study.

Patients age was 72,9 ± 9,28 years. We aimed for a minimonovision with a difference in SA between the emmetropic and myopic eye of 0,65 ± 0,28 diopters (D). The difference between the preoperative aimed and postoperative achieved SA in the emmetropic eye was an average of -0.27 dpt (range -1.58 D to +0.95 D) and in the myopic eye -0.26 D (range -1.83 D to +1.29 D). The BCVA after IOL implantation was -0.02 ± 0.06 LogMAR . The binocular UCVA measured at 6 weeks after cataract surgery for distance was 0.06 ± 0.08 LogMAR and for near 0.16 ± 0.15 LogMAR. A total of 140 patients (98%) had an UCVA of ≥ 0.2 LogMAR (6/9 or better) in distance and 105 patients (73%) an UCVA of ≥ 0.2 LogMAR (6/9 or better) in near. 

This study shows the high efficacy of the EMV IOL in combination with a mini-monovision to provide an excellent outcome for uncorrected distance, intermediate and near vision and a high spectacle independence.The nondiffractive enhanced monovision intraocular lens is safe, stable and reliable for implantation after cataract surgery.