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Bafna S, Gu X, Fevrier H, Merchea M. IRIS ® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation. Clin Ophthalmol 2023; 17:3123-3129. [PMID: 37877114 PMCID: PMC10591682 DOI: 10.2147/opth.s424195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose To determine the incidence of pseudophakic monovision among patients bilaterally implanted with monofocal intraocular lenses (IOLs) and to characterize the distribution of myopic offsets achieved. Patients and Methods This retrospective database study included data on patients receiving care from ophthalmologists who contributed to the Academy IRIS® (Intelligent Research In Sight) Registry. Anonymized data were collected, including patient age, ethnicity, procedure data (CPT code, date, laterality), and postoperative manifest refractive spherical equivalent (MRSE) in both eyes implanted with monofocal or monofocal toric IOLs. No data regarding IOL manufacturer, model, or power were collected. One primary outcome measure was the percentage of patients achieving monovision (defined as emmetropia within ±0.25 diopters [D] in one eye and a myopic offset of ≥0.50 D in the fellow eye) among all patients receiving bilateral monofocal IOLs at the time of cataract surgery between January 1, 2016, and September 1, 2019, with at least 90 days of follow-up. Other primary outcomes included the distribution and frequency of myopic offsets (anisometropia) between eyes. Results Of the 16,765 people receiving bilateral monofocal IOLs within the study period, 4796 (28.6%) achieved emmetropia in at least one eye, as defined by an MRSE within ± 0.25 D. The incidence of monovision among these patients was 34.2% (1638/4796). One-quarter (24.7%; 405/1638) of patients who achieved monovision had a myopic offset between 0.50 and 0.74 D, with more than one-third (35.2%; 576/1638) falling within 0.75-1.24 D and 18.0% within 1.25-1.74 D. A myopic offset ≥1.75 D was observed in 22.1% (362/1638) of patients who achieved monovision. Conclusion Pseudophakic monovision for presbyopia correction was achieved in ~34% of patients in the IRIS Registry bilaterally implanted with monofocal IOLs, with myopic offsets typically ranging from 0.5 to 1.24 D.
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Wróbel-Dudzińska D, Moura-Coelho N, Palma-Carvajal F, Zebdeh A, Manero F, Güell JL. Ten-year outcomes of pseudophakic mini-monovision correction of hyperopic presbyopia. J Cataract Refract Surg 2023; 49:367-372. [PMID: 36729769 DOI: 10.1097/j.jcrs.0000000000001116] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 12/06/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE To evaluate long-term efficacy, safety, and spectacle independence after the treatment of hyperopic presbyopia with pseudophakic mini-monovision using standard monofocal intraocular lenses (IOLs) after bilateral cataract surgery. SETTING Private practice in Barcelona, Spain. DESIGN Retrospective, noncomparative case series. METHODS Patients with hyperopic presbyopia underwent bilateral cataract surgery with pseudophakic mini-monovision using standard monofocal IOLs between 2008 and 2018. Main outcomes analyzed were uncorrected distance visual acuity (UDVA), uncorrected near distance visual acuity (UNVA), and rates of spectacle independence at postoperative day 1 (POD1), months 1, 6 and 12, and at 5 and 10 years (Y10) postoperatively. RESULTS The study enrolled 463 patients. Both UDVA and UNVA significantly improved postoperatively ( P < .05). The mean binocular UDVA improved from 0.47 ± 0.3 logMAR preoperatively to 0.096 ± 0.14 at POD1 to 0.16 ± 0.2 at Y10 ( P = .0033). The binocular UNVA was 0.05 logMAR at Y10, whereas in preoperative visits, all patients needed spectacles. The mean UDVA for the dominant eye ≤0.20 logMAR was achieved in 84.29% at the Y10. Self-reported and measured complete spectacle independence for near vision was achieved in 79.61% of patients at POD1 and 71.92% at Y10 postoperatively. For distance, respectively, in 86.29% of patients at POD1 and 78.43% at Y10. The achieved results were stable. No serious events were reported, as well as no photic phenomena. CONCLUSIONS Pseudophakic mini-monovision in hyperopic presbyopes is a safe, effective, and low-cost approach for the long-term correction of presbyopia. It significantly reduces spectacle dependence and fulfils patients' expectations after bilateral cataract surgery.
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Affiliation(s)
- Dominika Wróbel-Dudzińska
- From the Cornea and Refractive Surgery Unit, Instituto de Microcirugía Ocular, Barcelona, Spain (Wróbel-Dudzińska, Moura-Coelho, Palma-Carvajal, Zebdeh); Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Lublin, Poland (Wróbel-Dudzińska); Hospital CUF Cascais, Cascais, Portugal (Moura-Coelho); Instituto Português de Retina, Lisbon, Portugal (Moura-Coelho); NOVA Medical School | Faculdade de Ciências Médicas-Universidade Nova de Lisboa (NMS|FCM-UNL), Lisbon, Portugal (Moura-Coelho); Instituto Microcirurgia Ocular (IMO) Barcelona, Barcelona, Spain (Manero, Güell); Universidad Autónoma de Barcelona (UAB), Barcelona, Spain (Manero, Güell)
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Presbyopic LASIK using the Supracor algorithm and micromonovision in presbyopic myopic patients: 12-month visual and refractive outcomes. J Cataract Refract Surg 2023; 49:195-200. [PMID: 36325836 DOI: 10.1097/j.jcrs.0000000000001080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the visual and refractive outcomes for presbyopia and myopia treatment using the Teneo 317 M2 platform and the myopic Supracor algorithm. SETTING Percy Military Hospital and Private Laser Victor Hugo Center, Paris, France. DESIGN Observational retrospective nonrandomized study. METHODS 50 eyes (25 patients) treated with bilateral myopic Supracor and micromonovision using the Teneo 317 M2 platform and followed up for 12 months. Study outcomes included binocular and monocular visual acuities (without correction for distance and near vision), the spherical equivalent, predictability, stability, safety, optical aberrations, and complications. RESULTS The mean age was 50.6 ± 2.7 years, and the mean preoperative spherical equivalent was -2.6 ± 1.4 diopters. At 12 months postoperatively, the mean binocular uncorrected distance visual acuity was 0.02 ± 0.03 logMAR, and 24 patients (96%) achieved an acuity of 20/25 or better. The binocular uncorrected near visual acuity was equal to Jaeger 1 in 18 patients (72%) and Jaeger 2 or better in 23 patients (92%). 12 eyes (24%) had lost 1 Snellen line, and 1 eye (2%) had lost 2 Snellen lines of monocular corrected distance visual acuity. No cases required retreatment; however, 1 eye (2%) underwent revision surgery because of diffuse lamellar keratitis. CONCLUSIONS This study suggests that Supracor using the Teneo 317 M2 platform is a safe and effective technique for myopia and presbyopia treatment. Supracor is therefore a viable alternative to monovision for presbyopia and myopia. However, a careful patient selection is essential to satisfy realistic expectations.
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Xun Y, Wan W, Jiang L, Hu K. Crossed versus conventional pseudophakic monovision for high myopic eyes: a prospective, randomized pilot study. BMC Ophthalmol 2020; 20:447. [PMID: 33198710 PMCID: PMC7667742 DOI: 10.1186/s12886-020-01694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background Aiming at spectacle independence, conventional pseudophakic monovision has been widely used in myopia patients with bilateral monofocal intraocular lens implantation. However, the crossed monovision, which is to correct the dominant eye for near vision and the non-dominant eye for distant vision, has been mentioned preferable for high myopic cataract patients by some studies. We have conducted this study to compare clinical results to assess the feasibility of conventional and crossed monovision for high myopic pseudophakic patients by comparing patient satisfaction, visual function and spectacle independence. Method Forty-sixth high myopia patients were divided into two groups: 22 in crossed monovision group with patients whose refraction targeted to − 2.00 diopters (D) in the dominant eye and − 0.50D in the non-dominant eye; 24 in conventional monovision group with patients whose refraction targeted to − 0.50D in the dominant eye and − 2.00D in the non-dominant eye. Binocular uncorrected distance visual acuity (BUDVA), binocular uncorrected near visual acuity (BUNVA), binocular corrected distant visual acuity (BCDVA), binocular corrected near visual acuity (BCNVA), contrast visual acuity and stereoacuity were examined at postoperative 2 weeks, 1 month and 3 months. Questionnaires were completed by patients 3 months after binocular surgery to evaluate patients’ satisfaction and spectacle independence. Results The conventional monovision and the crossed monovision group showed no significant differences of mean BUDVA, BUNVA, BCDVA, BCNVA 2 weeks, 1 month or 3 months postoperatively (P > 0.05). There was no difference in the bilateral contrast sensitivity or stereoscopic function between the convention conventional and crossed monovision groups (P > 0.05). Patient satisfaction with near and distant vision, as well as spectacle dependence did not differ significantly between the two groups (P > 0.05). Conclusion Crossed pseudophakic monovision exhibited similar visual function when compared with conventional monovision technique, which indicates that it is an effective option to improve the visual functionality and quality of life for high myopic patients who considering bilateral cataract surgery. Trial registration The Institutional Review Board and Ethics committee of the First Affiliated Hospital of Chongqing Medical University, Chongqing, China. The trial registration was submitted in September 2018 and passed on March 18, 2020, and the registration number is: ChiCTR2000030935.
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Affiliation(s)
- Yan Xun
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400000, P.R. China
| | - Wenjuan Wan
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400000, P.R. China
| | - Lu Jiang
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400000, P.R. China
| | - Ke Hu
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400000, P.R. China.
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Bilbao-Calabuig R, Gónzalez-López F, Llovet-Rausell A, Ortega-Usobiaga J, Tejerina Fernández V, Llovet-Osuna F. Lens-based surgical correction of presbyopia. Where are we in 2020? ACTA ACUST UNITED AC 2020; 96:74-88. [PMID: 32868085 DOI: 10.1016/j.oftal.2020.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Presbyopia is the progressive and irreversible loss of accommodation due to aging. It is one of the main causes of loss of quality of life in people from 45 years of age, due to the, often novel, dependence on spectacles. The eagerness to correct it by ophthalmologists impulsed by the desire of millions of people who suffer from it, has become one of the main drivers for the development of intraocular lens (IOL) technology over the last twenty years. MATERIAL AND METHODS This review briefly presents the different alternatives that have allowed us to improve the crystalline lens surgical approach of presbyopia; from monofocal lenses and monovision technique, accommodative, refractive, and diffractive multifocal lenses, and finally the most recent extended depth of focus/field lenses known as EDOFs. RESULTS Each IOL has its advantages, limitations and disadvantages. Furthermore, there is no single lens that suits the needs of all patients. CONCLUSIONS It is necessary to know the variety of lenses available, and to have an in-depth understanding of their optical properties, as well as the impact that these will have later on their clinical performance and on the visual quality of the patients. This should help us to select the best alternative for each of them.
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Affiliation(s)
- R Bilbao-Calabuig
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España.
| | - F Gónzalez-López
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España
| | - A Llovet-Rausell
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Valencia, España; Servicio Oftalmología, Hospital Universitario La Fe, Valencia, España
| | - J Ortega-Usobiaga
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Bilbao, España
| | - V Tejerina Fernández
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España
| | - F Llovet-Osuna
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España; Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Valencia, España
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Accuracy of intraocular lens power calculation methods when targeting low myopia in monovision. J Cataract Refract Surg 2020; 46:862-866. [DOI: 10.1097/j.jcrs.0000000000000187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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García‐Montero M, Albarrán Diego C, Garzón‐Jiménez N, Pérez‐Cambrodí RJ, López‐Artero E, Ondategui‐Parra JC. Binocular vision alterations after refractive and cataract surgery: a review. Acta Ophthalmol 2019; 97:e145-e155. [PMID: 30218490 DOI: 10.1111/aos.13891] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
Abstract
To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperative binocular vision-related complaints. Most diplopia-related visual complaints, irrespective of the surgical procedure, were in fact misdiagnosed preoperative disorders. The preoperative evaluation of patients seeking spectacle/contact lens independence should include a complete binocular and accommodation assessment where parameters such as the phoric posture, accommodative amplitude and facility, near point of convergence, fusional reserves and accommodative convergence/accommodation coefficient are measured. This would allow the identification of risk factors that could compromise the success of the refractive surgery and cause clinical symptoms.
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Affiliation(s)
- María García‐Montero
- Optics II Department Faculty of Optics and Optometry Complutense University of Madrid Madrid Spain
| | - César Albarrán Diego
- Optics, Optometry and Visión Sciences Department Faculty of Physics University of Valencia Burjassot Spain
- Baviera Clinic Castellón de la Plana Spain
| | - Nuria Garzón‐Jiménez
- Optics II Department Faculty of Optics and Optometry Complutense University of Madrid Madrid Spain
- IOA Madrid Innova Ocular Madrid Spain
| | | | | | - Juan Carlos Ondategui‐Parra
- Centre of Development of systems, instrumentation and sensors (CD6) Universitat Politécnica de Catalunya Terrasa Spain
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Abstract
SIGNIFICANCE When fit with monovision, most early presbyopes (aged 40 to 50 years) accommodated to near objects by focusing the distance corrected eye, leaving the near corrected eye myopically defocused with reduced image quality. A few were able to switch focus to the near corrected eye retaining a consistently focused image in one eye over a wider range of distances. PURPOSE The aim of this study was to examine accommodation behavior, pupil responses, and resultant image quality of early presbyopes fit with either bilateral or unilateral (monovision) near adds. METHODS Accommodative response and pupil size of 19 subjects (27 to 60 years), including 13 early presbyopes (40 to 50 years), were measured using an aberrometer as a binocularly viewed 20/40 letter E was moved from 2 m to 20 cm. Each subject was fit with different refractive strategies: bilateral distance correction, bilateral +2 diopters (D) near add, and unilateral +2 D near add placed over the measured right eye or unmeasured left eye. Monochromatic image quality was quantified using the Visual Strehl ratio metric. RESULTS With bilateral +2 D near add, all early presbyopes mostly refrained from accommodating (gain = 0.22 D/D) until the target approached closer than the 50-cm far point, and they then accommodated accurately until their maximum accommodative amplitude was reached. With monovision, most (10 of 13 early presbyopes) accommodated to focus the distance corrected eye, leaving the near corrected eye myopically defocused with reduced image quality. As stimulus distance became closer than their distance corrected eye's near point, they continued to exert maximum accommodation. Only two early presbyopes relaxed their accommodation to "switch" focus to the near corrected eye as target distance was reduced, and these two did not experience bilateral drop in image quality as stimulus distance became closer than the near point of the distance corrected eye. CONCLUSIONS Our data suggest that many early presbyopes will not initially adopt an accommodation strategy that optimizes image quality with monovision, but consistently accommodate to focus the distance corrected eye.
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Hayashi K, Yoshida M, Sasaki H, Hirata A. Binocular visual function of myopic pseudophakic monovision. Jpn J Ophthalmol 2018; 62:357-364. [PMID: 29464487 DOI: 10.1007/s10384-018-0564-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/30/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare binocular visual function of myopic pseudophakic patients with myopic monovision to patients without monovision. STUDY DESIGN Randomized comparative study METHODS: Sixty patients were randomized to one of two groups: patients whose refraction was targeted to -2.75 diopters (D) in the dominant eye and -1.75D in the nondominant eye (myopic monovision group), and patients whose refraction was targeted to -2.75D bilaterally (non-monovision group). Binocular uncorrected and corrected visual acuity at various distances was measured using an all-distance vision tester, and contrast visual acuity and near stereoacuity were examined. RESULTS In the myopic monovision group mean refraction was -2.74D in the dominant eyes and -1.94D in the nondominant eyes, and in the non-monovision group it was -2.96D bilaterally. Mean binocular uncorrected distance (UDVA) and intermediate visual acuity (UIVA) from 0.5 m to 5.0 m were significantly better in the myopic monovision group than in the non-monovision group (P≤ 0.0134), while binocular uncorrected near visual acuity (UNVA) at 0.3 m did not differ significantly between groups. The distribution of UIVA and UDVA was significantly better in the myopic monovision group (P≤ 0.0035). Corrected visual acuity at any distance, photopic and mesopic contrast visual acuity, and stereoacuity did not differ significantly between groups. CONCLUSION Patients with myopic monovision exhibited significantly better binocular UIVA and UDVA than those without monovision, while UNVA, corrected visual acuity, contrast sensitivity, and stereoacuity were comparable between groups, suggesting that this method is useful for patients who want to see near and intermediate distances without spectacles.
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Affiliation(s)
- Ken Hayashi
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan.
| | - Motoaki Yoshida
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
| | - Hiroshi Sasaki
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
| | - Akira Hirata
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
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Balgos MJTD, Vargas V, Alió JL. Correction of presbyopia: An integrated update for the practical surgeon. Taiwan J Ophthalmol 2018; 8:121-140. [PMID: 30294526 PMCID: PMC6169332 DOI: 10.4103/tjo.tjo_53_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Presbyopia results from loss or insufficiency of the eye's accommodative ability, and clinically manifests as the inability to focus near objects on the retina. It is one of the most common causes of visual impairment worldwide especially in adults of productive or working age. Various means of compensating for the loss of accommodative ability have been devised from optical tools such as spectacles and contact lenses, to topical medications and to surgical procedures. A comprehensive search on journal articles about topical and surgical correction of presbyopia was undertaken. The various techniques for presbyopia correction, as enumerated in these articles, are discussed in this paper with the addition of our personal experience and perspective on the future of these techniques.
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Affiliation(s)
| | | | - Jorge L Alió
- VISSUM Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Spain
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12
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Labiris G, Toli A, Perente A, Ntonti P, Kozobolis VP. A systematic review of pseudophakic monovision for presbyopia correction. Int J Ophthalmol 2017; 10:992-1000. [PMID: 28730093 DOI: 10.18240/ijo.2017.06.24] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/23/2017] [Indexed: 11/23/2022] Open
Abstract
A systematic review of the recent literature regarding pseudophakic monovision as a reliable methods for presbyopia correction was performed based on the PubMed, MEDLINE, Nature and the American Academy of Ophthalmology databases in July 2015 and data from 18 descriptive and 12 comparative studies were included in this narrative review. Pseudophakic monosvision seems to be an effective method for presbyopia with high rates of spectacles independence and minimal dysphotopsia side-effects, that should be considered by the modern cataract surgeons.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece.,Eye Institute of Thrace, Alexandroupolis 68100, Greece
| | - Aspa Toli
- Eye Institute of Thrace, Alexandroupolis 68100, Greece
| | - Aslin Perente
- Eye Institute of Thrace, Alexandroupolis 68100, Greece
| | | | - Vassilios P Kozobolis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece.,Eye Institute of Thrace, Alexandroupolis 68100, Greece
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Kato S, Ito M, Shimizu K, Kamiya K. Etiology and outcomes of secondary surgical intervention for dissatisfied patients after pseudophakic monovision. Int Ophthalmol 2017; 38:1003-1009. [DOI: 10.1007/s10792-017-0551-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 05/10/2017] [Indexed: 11/28/2022]
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Greenstein S, Pineda R. The Quest for Spectacle Independence: A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia. Semin Ophthalmol 2016; 32:111-115. [DOI: 10.1080/08820538.2016.1228400] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ravikumar S, Bradley A, Bharadwaj S, Thibos LN. Expanding binocular depth of focus by combining monovision with diffractive bifocal intraocular lenses. J Cataract Refract Surg 2016; 42:1288-1296. [DOI: 10.1016/j.jcrs.2016.04.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/27/2016] [Indexed: 11/17/2022]
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Zhang F, Sugar A, Arbisser L, Jacobsen G, Artico J. Crossed versus conventional pseudophakic monovision: Patient satisfaction, visual function, and spectacle independence. J Cataract Refract Surg 2016; 41:1845-54. [PMID: 26603393 DOI: 10.1016/j.jcrs.2015.10.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/31/2014] [Accepted: 01/07/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare patient satisfaction, visual function, and spectacle independence in patients with crossed or conventional pseudophakic monovision. SETTING Department of Ophthalmology, Henry Ford Health System, Taylor, Michigan, USA. DESIGN Retrospective comparative cohort study. METHODS Cataract surgery patient records from June 1999 to December 2013 were reviewed. Crossed monovision patients were identified. Control conventional monovision cases were matched for age, sex, general health, personal lifestyle/main hobbies, preoperative refractive status, postoperative refractive status, uncorrected distance visual acuity, uncorrected near visual acuity, astigmatism level, and anisometropia level. A survey was mailed to participants, and results were independently analyzed. RESULTS The review comprised 7311 patient records. Forty-four crossed monovision patients were identified, and 30 of them were enrolled. Thirty matched pairs were surveyed. The mean anisometropia was 1.19 diopters (D) in the conventional and 1.12 D in the crossed monovision groups. No significant difference was identified for eye-hand coordination, eye-foot coordination, or sport-related depth perception, but satisfaction was slightly better in the crossed monovision group (P = .028). No significant difference was identified for 6 of 8 spectacle independence measures, but nighttime driving was a little easier for the crossed monovision group (P = .025). Seventy-seven percent of crossed and 50% of conventional monovision patients did not use glasses for intermediate distance activities (P = .037). CONCLUSION Crossed pseudophakic monovision appears to work as well as conventional pseudophakic monovision in terms of patient satisfaction and spectacle independence in patients with a mild degree of anisometropic pseudophakia. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Fuxiang Zhang
- From the Department of Ophthalmology (Zhang, Artico), Henry Ford Health System, Taylor, the Kellogg Eye Center (Sugar), University of Michigan, Ann Arbor, the Department of Biostatistics and Research Epidemiology (Jacobsen), Henry Ford Health System, Detroit, Michigan; Eye Surgeons Associates PC (Arbisser), Bettendorf, Iowa.
| | - Alan Sugar
- From the Department of Ophthalmology (Zhang, Artico), Henry Ford Health System, Taylor, the Kellogg Eye Center (Sugar), University of Michigan, Ann Arbor, the Department of Biostatistics and Research Epidemiology (Jacobsen), Henry Ford Health System, Detroit, Michigan; Eye Surgeons Associates PC (Arbisser), Bettendorf, Iowa
| | - Lisa Arbisser
- From the Department of Ophthalmology (Zhang, Artico), Henry Ford Health System, Taylor, the Kellogg Eye Center (Sugar), University of Michigan, Ann Arbor, the Department of Biostatistics and Research Epidemiology (Jacobsen), Henry Ford Health System, Detroit, Michigan; Eye Surgeons Associates PC (Arbisser), Bettendorf, Iowa
| | - Gordon Jacobsen
- From the Department of Ophthalmology (Zhang, Artico), Henry Ford Health System, Taylor, the Kellogg Eye Center (Sugar), University of Michigan, Ann Arbor, the Department of Biostatistics and Research Epidemiology (Jacobsen), Henry Ford Health System, Detroit, Michigan; Eye Surgeons Associates PC (Arbisser), Bettendorf, Iowa
| | - Jessica Artico
- From the Department of Ophthalmology (Zhang, Artico), Henry Ford Health System, Taylor, the Kellogg Eye Center (Sugar), University of Michigan, Ann Arbor, the Department of Biostatistics and Research Epidemiology (Jacobsen), Henry Ford Health System, Detroit, Michigan; Eye Surgeons Associates PC (Arbisser), Bettendorf, Iowa
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Ocular dominance, coexistent retinal disease, and refractive errors in patients with cataract surgery. Curr Opin Ophthalmol 2016; 27:38-44. [DOI: 10.1097/icu.0000000000000215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yoo R, Shin KC. Clinical Results of Pseudophakic Monovision 1 Year after Cataract Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.12.1882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Romi Yoo
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Hayashi K, Ogawa S, Manabe SI, Yoshimura K. Binocular visual function of modified pseudophakic monovision. Am J Ophthalmol 2015; 159:232-40. [PMID: 25448995 DOI: 10.1016/j.ajo.2014.10.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/21/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare binocular visual function of pseudophakic patients having modified monovision (0.75 diopter [D] anisometropia) with that of patients having conventional monovision (1.75 D anisometropia). DESIGN Prospective observational study. METHODS Eighty-two patients that underwent bilateral implantation of a monofocal intraocular lens were recruited at 3 months postoperatively. Modified monovision was simulated by adding a +0.75 D spherical lens to the nondominant eye, while conventional monovision was simulated by adding a +1.75 D spherical lens. Binocular corrected visual acuity (VA) at various distances, binocular contrast VA (contrast VA) and that with glare (glare VA), and stereoacuity were evaluated. RESULTS With modified monovision, mean binocular corrected intermediate VA at 1.0 m was 20/19 and near VA at 0.3 m was 20/51, and stereoacuity was 125 ± 100 seconds of arc. Mean binocular intermediate VA at 1.0 m was significantly better with modified monovision than with conventional monovision (P = .0001), while near VA and intermediate VA at 0.5 m were significantly worse (P < .0001). Mean binocular photopic and mesopic contrast VA and glare VA tended to be better with modified monovision than with conventional monovision, but the difference was not significant. Mean stereoacuity was significantly better with modified monovision than with conventional monovision (P = .0020). CONCLUSIONS Modified pseudophakic monovision provided excellent binocular VA from far to intermediate distances, although near VA was worse than that with conventional monovision. Contrast VA with and without glare tended to be better and stereoacuity was significantly better with modified monovision, suggesting that this method is useful for correcting presbyopia without marked impairment of binocular function.
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Kim J, Shin HJ, Kim HC, Shin KC. Comparison of conventional versus crossed monovision in pseudophakia. Br J Ophthalmol 2014; 99:391-5. [PMID: 25287366 DOI: 10.1136/bjophthalmol-2014-305449] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To compare the visual performances and patient satisfactions of conventional monovision, which corrects the dominant eye for distance vision, and crossed monovision, which corrects the non-dominant eye for distance vision in patients with pseudophakia. METHODS This prospective randomised study was conducted in 59 patients who underwent implantation of different targets of monofocal intraocular lens for each eye at Konkuk University Medical Center between November 2009 and August 2012. The following were examined before bilateral cataract surgery and 2 months after the surgery: refractive error, binocular uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), best corrected visual acuity (BCVA) and stereopsis. Questionnaires to evaluate postoperative spectacle dependence and patient satisfaction were completed by all patients. RESULTS The conventional monovision group and the crossed monovision group were composed of 28 and 31 patients, respectively. There were no significant differences in postoperative UCDVA, UCNVA, BCVA and stereopsis between the two groups. In addition, patient satisfaction with near and distant vision and spectacle dependence were not significantly different in the two groups. CONCLUSIONS The clinical results of the crossed monovision were not significantly different from the results of conventional monovision. Therefore, crossed monovision can also be a valuable option for correcting postoperative presbyopia in patients considering bilateral cataract surgery. TRIAL REGISTRATION NUMBER KCT0001065.
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Affiliation(s)
- Jaeyoung Kim
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyun Jin Shin
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyung Chan Kim
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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Binocular function in patients with pseudophakic monovision. J Cataract Refract Surg 2014; 40:1349-54. [DOI: 10.1016/j.jcrs.2013.11.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 11/14/2013] [Accepted: 11/15/2013] [Indexed: 11/19/2022]
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Labiris G, Giarmoukakis A, Patsiamanidi M, Papadopoulos Z, Kozobolis VP. Mini-monovision versus multifocal intraocular lens implantation. J Cataract Refract Surg 2014; 41:53-7. [PMID: 24962144 DOI: 10.1016/j.jcrs.2014.06.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/15/2014] [Accepted: 04/15/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the effect of monovision correction and multifocal intraocular lens (IOL) implantation on patient satisfaction, spectacle dependence, visual acuity, and dysphotopsia in cataract patients. SETTING University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece. DESIGN Prospective randomized trial. METHODS Patients with a diagnosis of senile cataract with stage 2 nuclear opalescence were randomly assigned to 2 groups: monovision and multifocal IOL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, Visual Function Index-14 (VF-14) scores, and spectacle dependence were assessed prior to surgery and 6 months postoperatively. RESULTS The monovision group comprised 38 patients and the multifocal IOL implantation group, 37 patients. Both techniques provided excellent refractive outcomes in UDVA and VF-14 scores (all P < .01). No significant intergroup differences were detected in VF-14 scores at the final postoperative examination. The monovision group patients presented significantly more spectacle dependence for near vision but less glare. CONCLUSIONS Monovision and multifocal IOL implantation provided excellent refractive outcomes for distance vision. Multifocal IOL insertion was associated with less dependence on glasses overall but significantly more dysphotopsia. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Georgios Labiris
- From the Department of Ophthalmology (Labiris, Patsiamanidi, Kozobolis), University Hospital of Alexandroupolis and the Eye Institute of Thrace (Labiris, Giarmoukakis, Papadopoulos, Kozobolis), Alexandroupolis, Greece.
| | - Athanassios Giarmoukakis
- From the Department of Ophthalmology (Labiris, Patsiamanidi, Kozobolis), University Hospital of Alexandroupolis and the Eye Institute of Thrace (Labiris, Giarmoukakis, Papadopoulos, Kozobolis), Alexandroupolis, Greece
| | - Maria Patsiamanidi
- From the Department of Ophthalmology (Labiris, Patsiamanidi, Kozobolis), University Hospital of Alexandroupolis and the Eye Institute of Thrace (Labiris, Giarmoukakis, Papadopoulos, Kozobolis), Alexandroupolis, Greece
| | - Zois Papadopoulos
- From the Department of Ophthalmology (Labiris, Patsiamanidi, Kozobolis), University Hospital of Alexandroupolis and the Eye Institute of Thrace (Labiris, Giarmoukakis, Papadopoulos, Kozobolis), Alexandroupolis, Greece
| | - Vassilios P Kozobolis
- From the Department of Ophthalmology (Labiris, Patsiamanidi, Kozobolis), University Hospital of Alexandroupolis and the Eye Institute of Thrace (Labiris, Giarmoukakis, Papadopoulos, Kozobolis), Alexandroupolis, Greece
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Arba Mosquera S, Alió JL. Presbyopic correction on the cornea. EYE AND VISION 2014; 1:5. [PMID: 26605352 PMCID: PMC4604121 DOI: 10.1186/s40662-014-0005-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 09/30/2014] [Indexed: 11/27/2022]
Abstract
Purpose The aim of this systematic review was to synthesize and appraise the evidence of the benefits of presbyopic correction on the cornea for visual function. Summary Comprehensive search was conducted in MEDLINE using keywords like “presbylasik”, “presbyopic refractive surgery”, “corneal pseudoaccommodation” and “corneal multifocality”. We reviewed corrected and uncorrected visual acuities for distance and near (uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), distance corrected near visual acuity (DCNVA), corrected near visual acuity (CNVA)), along with the refractive outcomes in spherical equivalent (SE) and astigmatism comparing the differences observed between preoperative myopic and hyperopic patients, as well as among techniques. Thirty-one studies met the inclusion and quality criteria. Monovision provides excellent distance and near uncorrected acuities, but with a 17% retreatment and a 5% reversal rate. Initial multifocal ablations result in 12% loss of 2 or more lines of CDVA, and a 21% retreatment rate. Laser Blended Vision provides excellent UDVA, but with a 19% retreatment rate. Initial experiences with Supracor show moderate predictability and a 22% retreatment rate. Intracor results in 9% loss of 2 or more lines of CDVA. KAMRA provides excellent UDVA, with only a 1% retreatment rate, but a 6% reversal rate. Initial experiences with PresbyMAX provided excellent UNVA and DCNVA, showing excellent predictability and a 1% reversal rate. Conclusions The findings have implications for clinicians and policymakers in the health-care industry and emphasize the need for additional trials examining this important and widely performed clinical procedure.
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Affiliation(s)
| | - Jorge L Alió
- Vissum Corporation, Alicante, Spain ; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
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Chung YK, Na JK, Kim MS. Target Refraction and Satisfaction of Patients with Binocular Myopia and Monocular Cataract. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.6.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Young Kwon Chung
- Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jong Kyoung Na
- Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Man Soo Kim
- Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea
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Ito M, Shimizu K, Kawamorita T, Ishikawa H, Sunaga K, Komatsu M. Association Between Ocular Dominance and Refractive Asymmetry. J Refract Surg 2013; 29:716-20. [DOI: 10.3928/1081597x-20130813-02] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 06/03/2013] [Indexed: 11/20/2022]
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