Subjective evaluation of uncorrected vision in patients undergoing cataract surgery with (diffractive) multifocal lenses and monovision

Stock, Ricardo Alexandre; Thumé, Thaís; Paese, Luan Gabriel; Bonamigo, Elcio Luiz

doi:10.2147/opth.s134541

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…Monovision by using monofocal lenses provides many advantages of the multifocal lenses without the photic adverse effects. Stock and coworkers 55 reported that glare occurred less often in patients implanted with monofocal IOLs using monovision than in those implanted with bilateral MFIOLs. Mu and coworkers 39 reported in a comparison study that patients receiving MFIOLs implantation complained of double vision, trouble in night vision, and halos more than those accepting monofocal IOL monovision.…”

Section: Discussionmentioning

confidence: 99%

Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials

Cao

Friedman

Jin

et al. 2019

Survey of Ophthalmology

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We compare multifocal intraocular lenses (MFIOLs) to monofocal IOLs for visual acuity (VA), contrast sensitivity, and adverse events using data from 21 randomized controlled trials with 2951 subjects. There was no statistical difference between uncorrected distance VA and corrected distance VA. Compared with monofocal IOLs, MFIOLs showed a better performance on uncorrected intermediate VA measured at 60 cm and uncorrected near VA; the mean differences were-0.06 (95% confidence interval [

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Section: Discussionmentioning

confidence: 99%

Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials

Cao

Friedman

Jin

et al. 2019

Survey of Ophthalmology

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“…Previous research has found that patients who receive either monofocal or multifocal IOL for cataract surgery have issues with night driving [ 13 ]. Other studies found that patients undergoing cataract surgery with multifocal IOLs experience more difficulties with night vision and night driving than patients undergoing cataract surgery with monovision [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Pseudophakic mini-monovision: high patient satisfaction, reduced spectacle dependence, and low cost

Goldberg

Shah

et al. 2018

BMC Ophthalmol

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BackgroundCataract surgery with pseudophakic mini-monovision has lower out-of-pocket patient expense than premium multifocal intraocular lenses (IOL). The purpose of this study was to evaluate patient-reported satisfaction and spectacle dependence for key activities of daily living after cataract surgery with pseudophakic mini-monovision. The study also examined statistical relationships between patient demographic variables, visual acuity and satisfaction.MethodsProspective cohort study of 56 patients (112 eyes) who underwent bilateral cataract surgery with pseudophakic mini-monovision. Mini-monovision corrects one eye for distance vision and the other eye is focused at near with − 0.75 to − 1.75 D of myopia. All patients with 1 diopter or greater of corneal astigmatism had a monofocal toric IOLs implanted or limbal relaxing incision. The main study outcomes were assessed at the last follow-up appointment and included refraction, visual acuity, patient reported spectacle use, and patient satisfaction. Descriptive statistics, correlation matrixes and Pearson’s chi-square tests were examined.ResultsUncorrected visual acuity was significantly better post-operatively. Most patients reported the surgery met their expectations for decreased dependence on spectacles (93%). Most patients report little or no use of spectacles post-operatively for computer use (93%), distance viewing (93%) and general use throughout the day (87%). A small number of patients report spectacle use for reading (9%) and night driving (18%). There were no relationships detected between demographic variables and visual acuity or patient satisfaction.ConclusionsAging of the population presents one of the biggest challenges in the health sector, which includes a rising number of individuals with chronic vision impairment and increased demand for accessible treatment strategies. Cataract surgery with pseudophakic mini-monovision results in high patient satisfaction and considerable reduction in spectacle dependence. Pseudophakic mini-monovision technique is a low-cost, valuable option for patients who would like to reduce dependence on spectacles post-operatively and should be considered along with premium multifocal IOLs in options available for patients based on their needs, preferences and clinical indicators. Reducing spectacle dependence with the pseudophakic mini-monovision technique could improve the functionality, independence and quality of life for many patients who are unsuitable or are unable to pay additional fees associated with premium multifocal IOLs.

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“…Other surgical options were considered for this patient such as monovision and pupil non-dependent MfIOL. A comparison of monovision to diffractive MfIOL has demonstrated similar results regarding visual acuity and spectacle independence [ 14 ]. However, the patient's lack of previous experience with monovision made this less likely of a possibility.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Multifocal Intraocular Lens Implantation in a Patient with Adie’s Pupil

LoBue¹,

Mano

Schaefer³

et al. 2018

Case Rep Ophthalmol

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Purpose: To report a case of a patient with unilateral Adie’s pupil who underwent bilateral cataract extraction with multifocal and monofocal posterior chamber intraocular lens (IOL) implantation. Methods: A 74-year-old woman presented to our institution complaining of worsening near vision. Gross examination revealed a 6-mm fixed pupil on the right eye (OD) and a 5-mm pupil reacting to 3 mm with light on the left eye (OS). Slit lamp examination revealed a tonic pupil with an exaggerated pupillary constriction to dilute pilocarpine OD. Dilated exam revealed 2–3+ nuclear and cortical lens changes bilaterally. The patient’s active lifestyle, personality, and biometry measurements made her a good candidate for multifocal IOL (MfIOL) implantation OS. Femtosecond laser-assisted cataract extraction with a ReSTOR +3 ADD (SN60D1) implantation was performed OS. Monofocal lens implantation (SN60WF) was performed OD 6 months later. Results: One year postoperatively, our patient had an uncorrected visual acuity (VAsc) of 20/15 for distance and J10 for near OD. Her VAsc was 20/25 +1 for distance and J1 for near OS. Visual acuity when using both eyes was 20/15 for distance and J1 for near. Conclusion: Optimizing success for MfIOL implantation is a multifactorial process. Large pupils preoperatively are of particular concern, as this may lead to increased dysphotopsia with pupil-dependent MfIOLs. Thus, patients with unilateral mydriasis, such as Aide’s pupil, may have a beneficial outcome combining multifocal-monofocal implantation after bilateral cataract extraction, especially if they are not a candidate for monovision but desire spectacle independence.

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Subjective evaluation of uncorrected vision in patients undergoing cataract surgery with (diffractive) multifocal lenses and monovision

Cited by 7 publications

References 14 publications

Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials

Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials

Pseudophakic mini-monovision: high patient satisfaction, reduced spectacle dependence, and low cost

Unilateral Multifocal Intraocular Lens Implantation in a Patient with Adie’s Pupil

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