Clinical Results of Pseudophakic Monovision 1 Year after Cataract Surgery

Romi Yoo; Ki Cheul Shin

doi:10.3341/jkos.2016.57.12.1882

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Yoo and Shin: Clinical Results of Pseudophakic Monovision 1 Year after Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2016;57(12):1882-1889.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.12.1882

Clinical Results of Pseudophakic Monovision 1 Year after Cataract Surgery

Romi Yoo, MD, Ki Cheul Shin, MD, PhD

Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

Address reprint requests to Ki Cheul Shin, MD, PhD Department of Ophthalmology, Konkuk University Medical Center, #120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: 82-2-2030-7655, Fax: 82-2-2030-5273 E-mail: 20050129@kuh.ac.kr

Received 28 April 2016 Revised 14 October 2016 Accepted 22 November 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

In this study, the visual performance and patient satisfaction one year after monovision cataract surgery and the results after 2 months.

Methods

Thirty patients who had bilateral cataract surgery between February 2010 and January 2014 treated with monovision therapy and received postoperative examinations for at least one year after surgery were enrolled in the present study. The eye with the more severe cataract had the surgery first and was corrected for distance vision targeted at emmetropia. The fellow eye was operated for near vision targeted to −1.50∼−2.50 diopter (D) range considering the patient's need for near task and pre-operative refractive errors 2–4 weeks after the first operation. Binocular uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), spherical equivalent, anisometropia, stereopsis, patient satisfaction for far and near distance, and spectacle dependence were evaluated preoperatively and two months and one year postoperatively.

Results

The mean age of patients was 71.9 years. Two months and one year after the surgery, the binocular UCDVA (log MAR) were 0.03 ± 0.10 and 0.08 ± 0.14, UCNVA were 0.21 ± 0.15 and 0.25 ± 0.14, anisometropia were 1.28 ± 0.68 and 1.29 ± 0.76 D, and stereopsis were 301.67 ± 251.28 and 251.67 ± 269.28 arcsec, respectively. One year after the surgery, the number of patients answering ‘Better’ or ‘Much better’ for distant vision was 27 (90%) and for near vision 22 (73.3%); 11 patients (36.7%) answered ‘Not dependent on spectacles at all’.

Conclusions

Monovision is an effective method to correct presbyopia after bilateral cataract surgery. Visual performances and patient satisfaction at one year after cataract surgery were not different compared with those at two months.

Keywords: Monovision, Presbyopia, Pseudophakic monovision

References

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Figure 1.

Post-operative (Post OP) binocular uncorrected visual acuity. (A) Distant vision. (B) Near vision. VA = visual acuity.

Figure 2.

Patients satisfaction for distant and near vision. (A) Satisfaction for distant vision. (B) Satisfaction for near vision. Post-OP = post-operative.

Figure 3.

Spectacle dependence. (A) Distant spectacle dependence.(B) Near spectacle dependence. Post-OP = post-operative.

Table 1.

Perioperative comparison of visual acuity, spherical equivalent, anisometropia, stereopsis

	Pre-OP	Post-OP
		2 months	1 year	p-value^*
		2 months	1 year	2 months	1 year	2 months vs. 1 year
UCDVA (log MAR)	0.21 ± 0.29	0.03 ± 0.10	0.08 ± 0.14	<0.001	<0.01	0.04
UCNVA (log MAR)	0.37 ± 0.27	0.21 ± 0.15	0.25 ± 0.14	<0.001	0.01	0.11
SE of distant target	0.49 ± 1.37	0.05 ± 0.43	–0.04 ± 0.50	0.10	0.06	0.85
SE of near target	–0.44 ± 2.12	–1.23 ± 0.53	–1.33 ± 0.55	0.01	0.01	0.34
Anisometropia (diopter)	1.09 ± 1.15	1.28 ± 0.68	1.29 ± 0.76	0.01	0.09	0.07
Stereopsis (seconds of Arc)	268.33 ± 279.50	301.67 ± 296.61	251.67 ± 269.28	0.76	0.32	0.44

Values are presented as mean ± SD unless otherwise indicated. Pre-OP = pre-operative; Post-OP = post-operative; UCDVA = uncorrected distant visual acuity; UCNVA = uncorrected near visual acuity; log MAR = logarithm of the minimum angle of resolution; SE = spherical equivalent.

^* Wilcoxon Signed-Rank test.

Table 2.

Preoperative and postoperative comparison of conventional vs. crossed group

		Conventional group (N = 14)	Crossed group (N = 16)	p-value^*
Pre-OP	UCDVA (log MAR)	0.12 ± 0.09	0.28 ± 0.37	0.63
	UCNVA (log MAR)	0.33 ± 0.16	0.41 ± 0.34	0.95
	SE of distant target	0.60 ± 1.22	0.41 ± 1.52	0.50
	SE of near target	–0.44 ± 1.70	–0.45 ± 2.47	0.64
	Anisometropia (diopter)	2.18 ± 1.68	2.88 ± 2.37	0.35
	Stereopsis (seconds of Arc)	211.43 ± 324.72	230.63 ± 237.47	0.95
Post-OP	UCDVA (log MAR)	0.02 ± 0.08	0.04 ± 0.12	0.61
2 months	UCNVA (log MAR)	0.22 ± 0.15	0.19 ± 0.15	0.62
	SE of distant target	0.04 ± 0.38	0.05 ± 0.49	0.79
	SE of near target	–1.22 ± 0.52	–1.25 ± 0.55	0.87
	Anisometropia (diopter)	1.50 ± 0.60	1.60 ± 0.57	0.56
	Stereopsis (seconds of Arc)	337.86 ± 315.89	270.00 ± 285.17	0.45
Post-OP	UCDVA (log MAR)	0.05 ± 0.11	0.10 ± 0.16	0.34
1 year	UCNVA (log MAR)	0.24 ± 0.14	0.27 ± 0.14	0.77
	SE of distant target	–0.13 ± 0.54	0.04 ± 0.46	0.27
	SE of near target	–1.29 ± 0.53	–1.37 ± 0.59	0.92
	Anisometropia (diopter)	1.73 ± 0.61	1.73 ± 0.67	0.87
	Stereopsis (seconds of Arc)	297.86 ± 295.04	211.25 ± 247.01	0.41

Values are presented as mean ± SD unless otherwise indicated. ‘Conventional group’ is ‘Dominant eye is corrected for distance vision’, and ‘Crossed group’ is ‘Non-dominant eye is corrected for distance vision’. Pre-OP = pre-operative; Post-OP = post-operative; UCDVA = uncorrected distant visual acuity; UCNVA = uncorrected near visual acuity; log MAR = logarithm of the minimum angle of resolution; SE = spherical equivalent.

^* Wilcoxon Rank-Sum test.

Table 3.

Factors associated with postoperative patient satisfaction

		Satisfied group (N = 26)	Dissatisfied group (N = 4)	p-value^*
Age		70.6 ± 7.21	80.5 ± 8.81	0.06
Pre-OP	UCDVA (log MAR)	0.20 ± 0.30	0.25 ± 0.31	0.69
	UCNVA (log MAR)	0.34 ± 0.25	0.57 ± 0.35	0.16
	SE of distant target	0.35 ± 1.33	1.41 ± 1.66	0.28
	SE of near target	–0.55 ± 2.18	0.19 ± 2.08	0.59
	Anisometropia (diopter)	2.43 ± 2.13	3.34 ± 1.90	0.18
	Stereopsis (seconds of Arc)	237.31 ± 233.24	470.00 ± 384.19	0.19
Post-OP	UCDVA (log MAR)	0.14 ± 0.08	0.15 ± 0.17	0.05
2 months	UCNVA (log MAR)	0.18 ± 0.12	0.37 ± 0.24	0.03
	SE of distant target	0.06 ± 0.41	–0.06 ± 0.63	0.60
	SE of near target	–1.24 ± 0.51	–1.22 ± 0.52	0.85
	Anisometropia (diopter)	1.53 ± 0.53	1.72 ± 0.74	0.93
	Stereopsis (seconds of Arc)	307.31 ± 281.81	265.00 ± 359.03	0.48
Post-OP	UCDVA (log MAR)	0.06 ± 0.13	0.16 ± 0.17	0.16
1 year	UCNVA (log MAR)	0.24 ± 0.12	0.34 ± 0.24	0.48
	SE of distant target	–0.03 ± 0.51	–0.09 ± 0.53	0.81
	SE of near target	–1.39 ± 0.50	–0.94 ± 0.52	0.18
	Anisometropia (diopter)	1.79 ± 0.56	1.34 ± 0.72	0.30
	Stereopsis (seconds of Arc)	239.62 ± 239.40	330.00 ± 352.33	0.92

^* Mann-Whitney test.

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