: VISUAL PERFORMANCE AFTER BILATERAL MICRO MONOVISION WITH EDOF LENS: DO WE REALLY NEED A DIFFRACTIVE IOL ANYMORE?

To evaluate visual acuity at all distances after binocular micro-monovision with Extended-dept-of-focus intraocular Lenses (EDOFs).

Special Eye Hospital “Dr. Kozomara” Banja Luka.

A retrospective monocentric study includes patients who underwent bilateral same-day RLE followed by implantation of EDOF lens in both eyes (Vivity®, Alcon Laboratories, Fort Worth, TX, USA). Inclusion criteria are patients older than 45 years of age with prescribed far, intermediate (if needed), and near vision correction. Exclusion criteria were patients younger than 45 years of age, those without presbyopia or hypermetropia, and other ocular pathologies.  Preoperative examination included testing of uncorrected (UDVA) and best-spectacle corrected far (BSCDVA), intermediate (BSCIVA), and near vision (BSCNVA), intraocular pressure measurement (IOP), pupil diameter, and slit lamp examination of anterior and posterior eye segments. IOL power calculation was done using the Barrett II formula. The data used for this study were collected at one month postoperatively.

50 patients (100 eyes) are included in the study. The mean preoperative UDVA was 0.44±0.32, UIVA 0.28±0.11, and UNVA 0.14±0.05, while BSCVA was 0.93±0.15, BSCIVA 1.00, and BSCNVA 0.94±0.13. Postoperatively, UDVA was 0.92±0.12, UIVA 1.00, and UNVA 0.84±0.16. The mean bilateral undercorrection was -0.27±0.28, and the mean IOL power was +24.70±3.60. The mean pupil diameter was 2.86±0.41, while the IOP value was 16.60±2.22. The mean keratometry value was 43.72±0.18 for the right eye, and 43.46±1.12 for the left eye. There was no IOL dislocation, nor the presence of PCO.

Bilateral micro monovision gives excellent postoperative vision results at all distances, followed by a slight decrease in far visual acuity and very satisfactory near vision. Future studies on a larger sample are needed to confirm these findings.