Comparison Of Vision, Spectacle Independence And Patient Satisfaction With Micro-Monovision Implantation Of Two Toric Aspheric Intraocular Lenses (Iols) In The Public Health Sector: Updated Results Of A Prospective Randomised Controlled Study.

To compare the visual outcomes, spectacle independence and patient satisfaction of bilateral implantation of either Toric monofocal plus IOLs or standard Toric aspheric monofocal IOLs, using a micro-monovision technique

University Hospital, London United Kingdom.

Patients with bilateral cataracts and corneal astigmatism of over 1.25 dioptres, and no significant other ocular comorbidities were randomised to receive either bilateral insertion of Alcon SN6ATX or the Eyhance Toric II IOL with micro-monovision. The refractive target of the dominant eye was 0.00 to -0.25D, with the target of the myopic eye -0.75 to -1.00D. Patients were masked to IOL allocation, and surgery was performed by senior surgeons using standardised surgical techniques. Patients were reviewed routinely at 2 weeks, and at 6 weeks and 6 months for research data collection. Visual outcomes, contrast sensitivity, stereoacuity and patient satisfaction data was collected. Defocus curves were performed at final appointments.

Thirty-seven patients randomised to the Alcon SN6ATX group (11M:26F, mean age 71.9 yrs), and thirty-one patients to the Eyhance Toric II group (9M:22F, 70.98 yrs) have completed 6-week follow-up. Mean unaided distance vision of the emmetropic eye in the Alcon group was 0.03 logMar (-0.16 to 0.20), and 0.06 (-0.16 to 0.34) in the Eyhance group (p=0.14). Mean unaided near vision of the emmetropic eye was 0.52 logMar in the Alcon group (0.28 to 0.88), and 0.40 in the Eyhance group (0.02 to 0.82) (p<0.05).  Seventy-five percent of the Alcon group (28 patients) used reading glasses after surgery, compared to 35.4% (11 patients) of the Eyhance group (p<0.01).

Significantly more patients in the Eyhance group achieved spectacle independence for distance, intermediate and near than the Alcon group with micro-monovision implantation. This supports the use of the Eyhance IOL in public health sector patients to reduce their dependence on spectacles following cataract surgery. We will present further data, including stereoacuity, contrast sensitivity or patient satisfaction; with larger groups and 6-month follow-up data.