Skip to main content

  • Partial Monovision for Presbyopia

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
    Add to My Bookmarks

    Journal Highlights

    Graefe’s Archive for Clinical and Experimental Ophthalmology
    Published online Feb. 17, 2022

    Download PDF

    Knecht et al. hypothesized that partial monovision (PMV) in presbyopic patients may be attained with a mono­focal IOL in one eye and a multifocal lens in the other. In a retrospective pilot study, they compared PMV and monofocal correction and found that PMV produced good visual results with minimal photopic effects.

    The two study groups were similar in distributions of age, gender, and type of surgery (cataract or clear lens extraction). Patients with other ocular diseases affecting VA were excluded. The PMV group underwent implan­tation of a monofocal IOL in the dominant eye three months before placement of a multifocal lens in the nondominant eye. The monofocal cor­rection group received monofocal IOLs in both eyes, with the intent to achieve slight anisometropia (0.0 D/ −0.50 D).

    Before and at least three months after IOL implantation, patients in both groups underwent assessment of uncorrected near, intermediate, and distance VA. Defocus curve and stereo acuity (Lang-Stereotest II) also were assessed. Refractive correction was used for contrast sensitivity testing. In addi­tion, patients were asked to complete questionnaires on their quality of vi­sion and visual function, and they were evaluated for spectacle independence and general satisfaction.

    The researchers assessed 27 patients with PMV and 28 with bilateral mono­focal correction. Outcomes in the PMV group were superior for uncorrected near VA (0.11 ± 0.08 vs. 0.56 ± 0.16 logMAR) and defocus curves (between −2 and −4 D); the between-group differences were significant for both parameters (p < .001). Uncorrected intermediate VA was slightly better in the PMV group (0.11 ± 0.10 vs. 0.20 ± 0.18 logMAR). The differences in uncorrected distance VA and contrast sensitivity were not significant. PMV produced better stereo vision (p = .008) and greater spectacle independence at all distances (near and intermedi­ate, p < .001; far, p = .012). Responses to the visual function questionnaire indicated that PMV was superior (p < .001). With regard to quality of vision, responses for frequency and severity of visual disturbances were similar for the two groups. Patient satisfaction was high in both groups.

    Overall, these results suggest that PMV is well suited for patients who wish to avoid spectacles, said the au­thors. Vision outcomes are good, and the photopic effects typical of bilateral multifocal correction are less common with the PMV approach.

    The original article can be found here.