Visual Function and Patient Satisfaction in Pseudophakic Monovision

Yoon Jeon Kim; Mi Hyun Cheon; Dong Ah Ko; Jae Yong Kim; Myoung Joon Kim; Hungwon Tchah

doi:10.3341/jkos.2012.53.11.1621

Journal List > J Korean Ophthalmol Soc > v.53(11) > 1009225

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Kim, Cheon, Ko, Kim, Kim, and Tchah: Visual Function and Patient Satisfaction in Pseudophakic Monovision

Original Article

Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(11): 1621-1629.

Published online: 19 November 2012

DOI: https://doi.org/10.3341/jkos.2012.53.11.1621

Visual Function and Patient Satisfaction in Pseudophakic Monovision

Yoon Jeon Kim, MD, Mi Hyun Cheon, MD, Dong Ah Ko, MD, Jae Yong Kim, MD, PhD, Myoung Joon Kim, MD, PhD, Hungwon Tchah, MD, PhD

Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address reprint requests to Hungwon Tchah, MD, PhD. Department of Ophthalmology, Asan Medical Center, #88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: 82-2-3010-3680, Fax: 82-2-470-6440, hwtchah@amc.seoul.kr

Received 10 March 2012 Accepted 24 September 2012

Abstract

Purpose

To evaluate visual performance as well as patient satisfaction and to explore factors associated with clinical outcomes in pseudophakic monovision acquired after bilateral phacoemulsification and sequential monofocal intraocular lens (IOL) implantation.

Methods

The present retrospective study examined patients with pseudophakic monovision. Preoperative and postoperative binocular uncorrected distant visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), refractive errors and postoperative near stereopsis were measured. Postoperative measurements were obtained at least 6 months after the fellow eye surgery. Patient satisfaction and independence from glasses were evaluated using a questionnaire.

Results

Preoperative and postoperative binocular UCDVA, UCNVA, and differences in spherical equivalent refractive error were statistically significant. Postoperative near stereopsis was 107.1 arcsec. Questionnaire responses showed that 71.4% of patients were less dependent on glasses and 85.7% were satisfied with the postoperative visual performance. Various designs of monovision, such as crossed monovision or customized minimonovision with moderate myopic defocus showed the same level of patient satisfaction. Patients who were older than 60 years or had poorer preoperative binocular UCDVA showed higher satisfaction.

Conclusions

Pseudophakic monovision is an effective approach for managing loss of accommodation after cataract surgery, especially in patients older than 60 years.

Keywords: Binocular uncorrected visual acuity, Monovision design, Patient satisfaction, Pseudophakic monovision, Stereopsis

Figures and Tables

Figure 1

Correlations between amounts of anisometropia and visual performace. (A) Correlation between amount of anisometropia and uncorrected near visual acuity (UCNVA) (Spearman rank correlation coefficient -0.23, p-value = 0.12). (B) Correlation between amounts of anisometropia and near stereopsis (Spearman rank correlation coefficient 0.67, p-value = 0.03).

Table 1

Comparison of perioperative characteristics between eyes for near and eyes for distance

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; MR se = manifest refraction spherical equivalent; IOL = intraocular lens.

^*Analyzed with Mann-Whitney U test ^†Analyzed with Fisher's exact test.

Table 2

Perioperative comparison of binocular uncorrected visual acuity (UCVA) and amount of anisometropia and perioperative changes of spectacle dependence

Values are presented as mean ± SD unless otherwise indicated.

UCDVA = un-corrected distant visual acuity; UCNVA = un-corrected near visual acuity.

^*Analyzed with Mann-Whitney U test.

Table 3

Comparison of visual performance according to target refraction of the dominant eye

Values are presented as mean ± SD.

UCDVA = un-corrected distant visual acuity; UCNVA = un-corrected near visual acuity.

^*Analyzed with Mann-Whitney U test.

Table 4

Factors associated with postoperative patient satisfaction

Values are presented as mean ± SD.

UCNVA = un-corrected near visual acuity; UCDVA = un-corrected distant visual acuity.

^*Analyzed with Fisher's exact test; ^†Analyzed with Mann-Whitney U test.

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