Evaluation of Quality of Vision and Visual Outcomes with Bilateral Implantation of a Non-Diffractive Extended Vision Intraocular Lens with a Target of Slight Myopia in the Non-Dominant Eye

Abstract

Purpose To assess the visual outcomes and quality of vision of patients receiving the AcrySof ® IQ Vivity™ non-diffractive extended vision intraocular lens (NDEV IOL) after uneventful cataract surgery when the non-dominant eye is targeted for slight myopia. Design Single site, prospective, single-arm study. Methods Eligible subjects interested in reducing their dependence on spectacles over a range of working distances were enrolled and followed for 3 months after the second eye surgery. Subjects were bilaterally implanted with this NDEV IOL, with a target of emmetropia in the dominant eye and a myopic refraction of −0.75D in the non-dominant eye. At 3 months postoperative, the uncorrected and distance-corrected (with monovision) visual acuity at 40 cm, 66 cm and 4 m were recorded, along with the manifest refraction. Questionnaires related to spectacle independence, patient satisfaction and quality of vision were also administered. Results Data from 33 subjects were analyzed. The mean difference between eyes by subject was 0.80 ± 0.37 D. Twenty-nine of 33 (88%) subjects had a binocular uncorrected near VA of 0.2 logMAR or better. Twenty-five of 33 eyes (76%) had a binocular distance-corrected (−0.75 D in the non-dominant eye) VA of 0.2 logMAR or better at all three test distances. Satisfaction with vision at all distances was high. The reported level of spectacle independence was higher than for the same lens without monovision. Visual disturbances were higher than has been previously reported for this lens but were not correlated to the level of monovision. Conclusion A target of −0.75 D of myopia in the non-dominant eye of patients bilaterally implanted with this NDEV IOL improved near vision, increasing the rate of spectacle independence in patients relative to those targeted for bilateral emmetropia, with no correlated increases in visual disturbances.

Evaluation of Visual and Patient—Reported Outcomes, Spectacle Dependence after Bilateral Implantation with a Non-Diffractive Extended Depth of Focus Intraocular Lens Compared to Other Intraocular Lenses

“…The use of the minimonovision system in the case of the Vivity lens improves the VA for near vision and increases the degree of independence from ocular correction. In the paper by Newsom T. et al describing the results of binocular Vivity lens implantation with target of slight myopia −0.75 D, 29 of 33 eyes achieved UCNVA binocular 0.2 logMAR or better [ 24 ]. Very similar results were obtained in our patients wih minimovision, whose median binocular UCNVA was 0.2 logMAR.…”

“…As you know, the use of a minimovision system in the cases of the Vivity lens improves near vision acuity and increases the degree of independence from spectacle correction. Newsom T. et described a high level of satisfaction and a greater degree of independence from ocular correction with the monovision system than without monovision with implantation of the same lens [ 24 ].…”

“…A paper by Newsom T. et described that the use of a monovision system when implanting a Vivity lens compared to target refraction set to emmetropia does not increase the frequency of photic phenomena [ 24 ].…”

The Connection between High Myopia Patients and MiR-708a or MiR-148 Expression Levels in Aqueous Studies of Visual Acuity

“…Some researchers demonstrated that multifocal IOLs were more prone to visual disturbance than EDOF lenses, but others reported no difference [ 9 , 10 ]. Previously studied EDOF and multifocal IOLs are related to higher rates of visual disturbance compared to monofocal IOLs [ 7 ], however which may be addressed by EDOF lens with monovision correction since IOL effect and monovision offset will produce cumulative effects [ 11 ]. Besides, relative to traditional implantable collamer lens (ICL) without central hole, it is more effective in diminishing major postoperative complication, cataract [ 12 , 13 ], possibly due to the improved aqueous humor (AqH) circulation to the crystalline lens anterior surface [ 14 ].…”

Analysis of uncorrected near visual acuity after extended depth-of-focus AcrySof® Vivity™ intraocular lens implantation

“…Mini-monovision or micro-monovision has been used to compensate for the relatively small power of extended depth-of-focus IOLS. Newsom and Potvin reported favorable results of −0.75 D monovision in the nondominant eye, in terms of improved near vision, increasing the rate of glasses independence [ 26 ]. In our study, eyes with an sSE lower than -0.50 D had poorer UDVA than other eyes, although there was no significant gain in UNVA compared with eyes that had an sSE between -0.50 and 0.00 D. These data suggest that micro-monovision within -0.50 D would result in a favorable outcome for UDVA and UNVA.…”