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Monovision still an effective alternative to presbyopia-correcting IOLs
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WAIKOLOA, Hawaii — Kendall E. Donaldson, MD, MS, said there is a lack of surgeon confidence in the current technology for presbyopia-correcting IOLs and only 9% of survey respondents use this type of IOL, according to data from the ASCRS.
The majority of respondents from the same survey, 57%, reported having an issue with the quality of vision achieved, she said.
“Twenty-five percent of our patients are getting monovision correction at time of cataract surgery as compared to 9% that are getting a presbyopia-correcting IOL,” Donaldson added.
There are many options for surgical correction of presbyopia, “but clearly when we have so many options to treat one condition, we don’t have the right answer, yet,” she said.
Donaldson outlined the facts and fallacies around monovision.
She said it is a myth that monovision is no longer fashionable and more expensive presbyopia-correcting IOLs have replaced monovision.
“Monovision still survives and is the most common form of presbyopia correction,” Donaldson said.
She said 93% of her monovision cases have freedom from spectacles.
Monovision may be the best option for patients where cost is a big concern, those who have a history of enjoying monovision, and those who are highly motivated and not willing to accept dysphotopsias.
She said some of the benefits of monovision are that it maintains visual quality, is easy to simulate with contact lenses, avoids unpredictable dysphotopsias, provides a high degree of spectacle independence and is cost effective.
For successful monovision she said to choose patients wisely, set accurate expectations before surgery and offer a trial before surgery with contact lenses, the phoropter or a trial frame. – by Abigail Sutton
Reference: Donaldson KE. Monovision: An alternative to presbyopia correcting IOLs. Presented at: Hawaiian Eye; Jan. 19-25, 2019; Waikoloa, Hawaii.
Disclosures: Donaldson reports financial interests with Alcon, Allergan, Bausch + Lomb, Biotissue, Johnson & Johnson, Omeros, Shire and Sun.