Micro-monovision with non-diffractive EDOF IOL yields spectacle independence for some

Most patients implanted bilaterally with a non-diffractive extended depth of focus intraocular lens (EDOF IOL) targeting micro-monovision ended up with good distance vision, and many achieved spectacle independence, Elizabeth Law PhD, MSc, MCOptom said at a presented poster session Saturday.

The results came from a retrospective study of the first 30 patients bilaterally implanted with the Rayner EMV EDOF IOL, which uses positive spherical aberration to stretch the focal distance. Patients were assessed 12 to 15 months postoperatively. Mean age was 69.05±8.87.

Dominant eyes aimed for emmetropia and non-dominant eyes for -0.75 D to -1.25 D. Patients’ previous experience with monovision determined the targeted myopia in the non-dominant eye. Those with no monovision experience targeted closer to -0.75 D, while those with experience targeted closer to -1.25 D, said Dr Law of Southend University Hospital, Mid and South Essex NHS Trust and BMI Southend Private Hospital, both in the United Kingdom.

GOOD DISTANCE VISION

In the dominant eye, mean uncorrected distance visual acuity was slightly worse than 0.1 logMAR, or about 20/25, while it was a little better than 0.3, or about 20/40, in the non-dominant eye. Binocular uncorrected distance vision was slightly better than 0.1. Mean corrected distance vision was 0.0, or 20/20, in each eye separately and slightly better than 0.0 binocularly, Dr Law reported. However, “nobody wore spectacles for distance vision even though it was slightly better corrected, and none were unsatisified,” she said.

The study allowed patients with up to 1.0 D corneal astigmatism to be implanted, which may explain why mean distance vision improved with correction, Dr Law said. “Perhaps we were not quite stringent enough in treating astigmatism in these patients.”

INTERMEDIATE AND NEAR VISION

Not surprisingly, mean uncorrected intermediate vision was significantly better in the non-dominant eye and binocularly than in the dominant eye, coming in at better than 0.2 in the non-dominant eye and binocularly, and a little better than 0.4 in the dominant eye. Near vision was slightly worse, at a mean of about 0.3 in the non-dominant eye and binocularly, and about 0.5 for the dominant eye.

The binocular defocus curve was also better than monocular performance, yielding a mean uncorrected visual acuity of better than 0.2 from +0.75 D to -1.50 D for the micro-monovision approach, Dr Law said. There were no reports of dysphotopsias in the group.

“We certainly have achieved an extended range of focus. A lot of our patients are spectacle independent,” Dr Law said. She disclosed that she is doing a longer-term study of the same lens, sponsored by Rayner.

Tags: 40th Congress of the ESCRS