Exploring The Effect On Stereoscopic Vision After Mini-Monovision Approach In Cataract Patients With Non-Diffractive Enhanced Monofocal Intraocular Lens (Iol)

RayOne EMV (RAO200E, Rayner) is an enhanced monofocal intraocular lens (IOL) with increased range of vision and a non-diffractive optic design. The goal of this study was to assess binocular visual acuities and the effect of mini-monovision on stereoscopic vision of patients who were bilaterally implanted with RayOne EMV IOL after cataract surgery. 

Citadelle Hospital, Liège, Belgium, Ophthalmology department

In this retrospective study patients with bilateral implantation of RayOne EMV IOLs using a mini-monovision approach were analysed. Target refraction in the non-dominant eye was between -0.5 D and -1.0 D and emmetropia in the dominant eye. At 3 months following IOL implantation, binocular and monocular, uncorrected, and best- or distance-corrected visual acuities (VAs) were measured at far (6 m), intermediate (66 cm) and near (40 cm) distances. Moreover, stereoscopic vision was measured with and without optical correction using Distance Randot^® test at far, and Titmus and TNO tests at near distance, respectively. 

20 patients with an average of 74.1years (range 57 to 84) were analysed.Manifest refraction spherical equivalent (MRSE) was -0.72D for non-dominant eye and -0.25D for dominant eye.Binocular uncorrected and corrected VAs at all distances were found significantly improved compared with monocular VAs (p<0.05).CD­VA was -0.08±0.07 and -0.13±0.05 logMAR,respectively monocular and binocular.DCIVA was 0.39±0.09 and 0.31±0.08 logMAR, respectively monocular and binocular.DCNVA was 0.62±0.14 and 0.49±0.12 logMAR, respectively monocular and binocular.Distance stereoscopy was found 111.7± 121.1 and 97.5±104.7 arcsecond,respectively with or without correction(p=0.28).No correlation was found between the monovision range and the stereoscopic performance.

These results suggest that a 0.47 D difference between the eyes to achieve mini-monovision with binocular implantation of RayOne EMV IOLs can provide a very good binocular vision to the patients with very good visual acuities from far to intermediate distances. In addition, a useful near visual acuity can be achieved. Moreover, mini-monovision did not seem to disturb stereoscopic vision in this investigation. Further studies are needed to confirm these findings.