Comparison Of Vision, Spectacle Independence And Patient Satisfaction With Micro-Monovision Implantation Of Two Toric Aspheric Intraocular Lenses (Iols) In The Public Health Sector: Final 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.

Forty-four patients randomised to the Alcon SN6ATX group (14M:30F, mean age 72.2 yrs), and forty-three patients to the Eyhance Toric II group (14M:29F, 68.1 yrs) completed 6-month follow-up. Mean binocular unaided distance vision was comparable between the two groups (p=0.75). Mean binocular unaided near vision (logMAR) was -0.28 in the Alcon group (SD 0.14), and 0.18 in the Eyhance group (SD 0.13) (P=0.0005). Mean binocular unaided near vision (N-chart) was 7.67 in the Alcon group (SD 3.05), and 5.97 in the Eyhance group (SD 1.82) (P=0.0006).  Sixty-five percent (28 out of 43) of Eyhance Toric patients reported glasses independence when in photopic conditions, compared to 20% (9 out of 44) in the Alcon group (p<0.0001).

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 Toric II 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.