ESCRS - FP01.05 - Halo Perception And Contrast Sensitivity In Simulated Partial Monovision Versus Bilateral Trifocal Configuration: Does Ocular Dominance Matter?

Halo Perception And Contrast Sensitivity In Simulated Partial Monovision Versus Bilateral Trifocal Configuration: Does Ocular Dominance Matter?

Published 2026 - 44th Congress of the ESCRS

Reference: FP01.05 | Type: Free paper | DOI: 10.82333/vftn-4d91

Authors: Dr Vitus André Knecht* 1 , Dr Ricardo Elsner 1 , Jasmin Abu Arif 1 , Josefine Brüch 2 , A/Prof. Eckart Bertelmann 1

1Department of Ophthalmology,Charité – Universitätsmedizin Berlin,Berlin,Germany, 2Berliner Hochschule für Technik,Berlin,Germany

Purpose

To evaluate the influence of motor and sensory ocular dominance on binocular halo perception, contrast sensitivity (CS), and distance visual acuity (VA) in simulated Partial Monovision (PMV) using a trifocal and a monofocal intraocular lens (IOL), compared with bilateral trifocal implantation.

Setting

Department of Ophthalmology, University Hospital, Germany.

Methods

Thirty-six phakic subjects (age 21–30) were examined using the Real-Artificial-Lens-Vision (RALV) system (DEZIMAL/1stQ GmbH, Germany). Three binocular IOL configurations were simulated under mesopic conditions: bilateral trifocal (TT; Basis Z Trifokal, 1stQ, +3.50 D add), monofocal right/trifocal left (MT), and trifocal right/monofocal left (TM; Basis Z mono, 1stQ). Binocular visual acuity, contrast sensitivity (logCS), and halo size (RALV-integrated halo test; mrad) were assessed. Motor dominance was determined by Porta test, sensory dominance by fogging (1.5/2.5 D), and binocular fusion by Worth four-dot test. Non-parametric statistics (Friedman, Wilcoxon with Bonferroni; α=0.017) were applied after Shapiro-Wilk testing.

Results

Halo size was significantly larger with TT (13.0±2.1 mrad) than MT (7.5±1.5; p<0.001; d=2.16) and TM (7.8±1.9; p<0.001; d=2.21); MT and TM did not differ (p=0.130). CS was lower with TT (1.19±0.10 logCS) versus MT (1.30±0.11; p<0.001; d=0.81) and TM (1.29±0.12; p<0.001; d=0.68); no MT–TM difference (p=0.327). Distance VA was comparable across groups (Friedman p=0.242). Neither motor dominance (Porta test; halo: p=0.822; CS: p=0.632; VA: p=0.132) nor sensory dominance (fogging; halo: p=0.747; CS: p=0.842; VA: p=0.527) significantly influenced outcomes when comparing monofocal IOL placement on the dominant versus non-dominant eye.

Conclusions

Simulated partial monovision significantly reduced halo perception and improved CS compared to bilateral trifocal implantation. Neither motor nor sensory ocular dominance significantly influenced binocular visual outcomes. These findings suggest that the choice of which eye receives the monofocal IOL in a partial monovision approach may not need to be guided by dominance testing.