Monovision By Implantation Of Posterior Chamber Phakic Intraocular Lens For Moderate Myopic Presbyopes

To describe our experience with monovision ICL surgery in individuals with  moderate myopic presbyopia.

Dongguan Aier Eye Hospital

This prospective interventional case series was conducted  on 20 patients with presbyopia aged 39-56 years old（42.5±3.53 years old）, who were treated with monovision ICL between 2022 and 2023. The dominant eye was corrected for distance vision and the nondominant eye was corrected for near vision, with anisometropia of -0.50~-1.00 diopters (D). All patients underwent comprehensive objective and subjective visual assessments and preoperative and postoperative  ADD, PRA, NRA. The follow-up time was at 1 day, 1 week, 1 month, 3 months, and 6 months. Contrast sensitivity and distance and near stereopsis are tested using the Binoptometer 4P binocular vision instrument. The safety index (SI) and the efficacy index (EI) were also assessed. 

SI of the dominant eye was 1.25±0.20, EI at 6 months post-ops was 1.40±0.16. SI of the non-dominant eye was 1.09±0.16, and EI at 6 months post-ops was 0.96±0.19.The proportion of binocular near vision reaching J2 at or beyond 3 months postoperatively was 76%.The preoperative ADD was +0.51±0.10, and postoperative ADD was +0.54±0.11, with no statistically significant difference (P>0.05). Preoperative NRA and PRA were 1.74±0.10 and -1.41±0.13, respectively, and postoperative NRA and PRA were 1.76±0.09 and -1.30±0.06, respectively, with no statistically significant differences (P>0.05).The dominant eye performed better than the non-dominant eye at all spatial frequencies (P < 0.05).

Monovision ICL provides both effective and safe results and should be considered as an option for individuals with moderate myopic presbyopia.