Clinical Study of Changes in Eye Dominance after Pseudophakic Conventional Monovision

Minsub Lee; Ki Cheul Shin

doi:10.3341/jkos.2019.60.6.534

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Lee and Shin: Clinical Study of Changes in Eye Dominance after Pseudophakic Conventional Monovision

Original Article

J Korean Ophthalmol Soc 2019;60(6):534-540.

Published online: 25 September 2019

DOI: https://doi.org/10.3341/jkos.2019.60.6.534

Clinical Study of Changes in Eye Dominance after Pseudophakic Conventional Monovision

Minsub Lee, MD, Ki Cheul Shin, MD, PhD

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

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

Received 8 November 2018 Revised 31 January 2019 Accepted 17 May 2019

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

The purpose of this study was to evaluate whether eye dominance changes after conventional pseudophakic monovision, and to identify factors that affect changes in eye dominance.

Methods

This retrospective study included 70 patients who underwent bilateral conventional monovision cataract surgery. Patients were divided into two groups based on whether they experienced a change in the dominant eye. We compared patients' uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), best-corrected visual acuity (BCVA), spherical equivalent, stereopsis, and time interval between cataract surgeries.

Results

The mean age was 71.26 ± 10.84 (range, 25–90) years, mean interval between surgery in each eye was 118.46 ±183.50 (range, 17–1,018) days, and mean postoperative diopter difference was 1.16 ± 0.53 (range, 0.00–2.75) diopters. After bilateral cataract surgery, 22 patients (31.43%) experienced a change in eye dominance, whereas 48 patients (68.57%) experienced no change. There were no differences in the time interval between cataract surgeries, preoperative UCDVA and UCNVA, pre- and postoperative BCVA, or stereopsis in either group. Patients who experienced a change in eye dominance showed smaller differences between preoperative and postoperative spherical equivalent, compared with patients who experienced no change in eye dominance (t-test, p < 0.05).

Conclusions

Twenty-two (31.43%) patients whose nondominant eyes were targeted for near vision showed altered eye dominance after conventional monovision cataract surgery. Eye dominance shows greater plasticity in patients with smaller differences between preoperative and postoperative spherical equivalent.

Keywords: Bilateral cataract surgery, Conventional pseudophakic monovision, Presbyopia, Ocular dominance

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Figure 1.

Comparison of Preoperative spherical equivalent difference of both eyes (the magnitude of anisometropia) between changed eye dominance group and unchanged eye dominance group. There are significant differences between the two groups (p = 0.01, t-test).

Table 1.

Baseline characteristics of patients

	Changed eye dominance group	Unchanged eye dominance group	p-value
Patients	22 (31.4)	48 (68.6)
Age (years)	70.5 ± 11.3	71.6 ± 10.7	0.70^*
Gender
Male	2 (9.1)	13 (35.1)	0.12^†
Female	20 (90.9)	35 (72.9)
Dominant eye
Right	11 (50.0)	26 (54.2)
Left	11 (50.0)	22 (45.8)

Data are expressed as mean ± standard deviation or number (%).

^* Mann-Whitney U test

^† Fisher's exact test.

Table 2.

Comparison of spherical equivalent between changed group and unchanged group

	Changed eye dominance group	Unchanged eye dominance group	p-value^*
Number of eyes	22 (31.4)	48 (68.6)
Time interval between cataract surgeries	109.50 ± 125.77	122.56 ± 205.70	0.78
Preoperative spherical equivalent of the dominant eye	0.13 ± 1.29	−0.74 ± 2.45	0.20
Preoperative spherical equivalent of nondominant eye Preoperative spherical equivalent difference	0.09 ± 1.35 0.39 ± 0.31	−0.68 ± 2.87 0.84 ± 1.07	0.30 0.01^†
Postoperative spherical equivalent of the dominant eye	−1.26 ± 0.51	−0.16 ± 0.57	<0.01
Postoperative spherical equivalent of nondominant eye	−0.11 ± 0.38	−1.23 ± 0.67	<0.01
Postoperative spherical equivalent difference	1.15 ± 0.40	1.17 ± 0.59	0.87

Values are expressed as mean ± standard deviation or number (%).

^* Mann-Whitney U test

^† t-test.

Table 3.

Comparison of visual acuity between changed group and unchanged group

	Changed eye dominance group	Unchanged eye dominance group	p-value^*
Preoperative UCDVA (logMAR)
Dominant eye	0.30 ± 0.24	0.35 ± 0.25	0.30
Non-dominant eye	0.31 ± 0.28	0.36 ± 0.27	0.40
Preoperative UCNVA (logMAR)
Dominant eye	0.48 ± 0.22	0.66 ± 0.39	0.08
Non-dominant eye	0.47 ± 0.26	0.64 ± 0.39	0.16
Preoperative BCVA (logMAR)
Dominant eye	0.25 ± 0.18	0.31 ± 0.24	0.50
Non-dominant eye	0.17 ± 0.13	0.23 ± 0.24	0.72
Postoperative UCDVA (logMAR)
Dominant eye	0.20 ± 0.16	0.10 ± 0.15	<0.01
Non-dominant eye	0.07 ± 0.11	0.19 ± 0.16	<0.01
Postoperative UCNVA (logMAR)
Dominant eye	0.20 ± 0.11	0.52 ± 0.34	<0.01
Non-dominant eye	0.46 ± 0.27	0.29 ± 0.25	<0.01
Postoperative BCVA (logMAR)
Dominant eye	0.03 ± 0.05	0.04 ± 0.05	0.95
Non-dominant eye	0.02 ± 0.03	0.04 ± 0.06	0.12

Values are expressed as mean ± standard deviation unless otherwise indicated.

UCDVA = uncorrected distant visual acuity; logMAR = logarithm of the minimum angle of resolution; UCNVA = uncorrected near visual acuity; BCVA = best corrected visual acuity.

^* Mann-Whitney U test.

Table 4.

Comparison of stereopsis between changed group and unchanged group

	Changed eye dominance group	Unchanged eye dominance group	p-value^*
Preoperative stereopsis	234.50 ± 216.13	229.21 ± 230.28	0.46
Postoperative stereopsis	248.00 ± 265.42	250.43 ± 256.64	0.80

Values are expressed as seconds of arc. Values are expressed as mean ± standard deviation unless otherwise indicated.

^* Mann-Whitney U test.

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