Hybrid monovision

Hybrid monovision may offer an effective approach for managing loss of accommodation in select cataract patients, while reducing some of the problems sometimes seen with multifocal IOL implantation. Bilateral multifocal IOL implantation is currently the most popular surgical approach for treatment of presbyopia. However, problems include glare and halo, loss of contrast and a high level of lens exchange. Moreover, this approach is not optimal for patients with glaucoma, retinal or macular disease. Researchers in Kanagawa, Japan, implanted 32 patients with a monofocal IOL (AQ310Ai) in the dominant eye and a diffractive multifocal (Tecnis ZM900) in the contralateral eye. They targeted both eyes for emmetropia. All eyes achieved mean binocular visual acuity better than 0.1 logMAR at all distances. Binocular contrast sensitivity was better than monocular vision in the eye with the diffractive multifocal IOL. Near stereopsis within normal range was maintained in 62.5 per cent of patients. Some 18.8 per cent of patients reported spectacle dependence. With binocular vision, no patients reported waxy vision. The main cause of dissatisfaction was the lack of visual clarity at near and intermediate distances. Therefore, the researchers note that this option may not be best for patients whose work or lifestyle requires excellent near vision.

Y Ida et al., JCRS, 'Pseudophakic monovision using monofocal and multifocal intraocular lenses: Hybrid monovision “ Volume 37, No. 11, 2001-2005.'