Bilateral Panoptix Iol Implantation Using A Mini-Monovision Strategy In Myopic Patients

To evaluate the clinical outcomes of the mini-monovision strategy in myopic patients following bilateral implantation of the PanOptix IOL.

This prospective clinical study included patients with varying degrees of myopia who underwent phacoemulsification with implantation of the PanOptix  intraocular lens. A total of 47 patients (18 males and 29 females) were enrolled. The mean age was 63.12 ± 10.29 years. All participants underwent comprehensive preoperative ophthalmological examination.

The mini-monovision refractive strategy aimed for emmetropia in the dominant eye and planned residual myopia of −0.75 to −1.25 diopters in the non-dominant eye. Postoperative evaluation included uncorrected distance, intermediate, and near visual acuity, manifest refraction, and subjective patient satisfaction with visual outcomes. The follow-up period ranged from 1 to 3 months. All surgeries were performed by a single surgeon at the Kazakh Research Institute of Eye Diseases.

Preoperative best-corrected visual acuity(BCVA) was 0.29±0.3 in the dominant eye and 0.33±0.3 in the non-dominant eye. Postoperative uncorrected visual acuity(UCVA) in the dominant eye was 0.92±0.2 for distance, 0.78±0.15 for intermediate, and 0.82±0.25 for near vision. Corresponding values in the non-dominant eye were 0.85±0.23, 0.86±0.3, and 0.90±0.4,respectively. Binocular UCVA reached 0.92±0.2 for distance and 0.89±0.1 for near vision. The mean postoperative spherical equivalent was −0.4±0.4D in the dominant eye and −1.15±0.4D in the non-dominant eye,consistent with the intended mini-monovision strategy. The dominant eye demonstrated superior distance vision,whereas the non-dominant eye showed a tendency toward better near performance. 

The present study demonstrates that mini-monovision in myopic patients undergoing bilateral PanOptix IOL implantation may be an effective strategy to expand the functional range of vision. Neuroadaptation represents an important consideration in this population. Many myopic patients have long benefited from uncorrected near vision, and abrupt bilateral emmetropization may be perceived as a loss of habitual visual function. The mini-monovision approach facilitates a smoother transition to a new optical system by preserving high-quality distance vision through the dominant eye while enhancing near functionality through the non-dominant eye.