Monovision may still be considered but be prepared for tradeoffs
Click Here to Manage Email Alerts
WAIKOLOA, Hawaii — Monofocal IOLs remain an important option in cataract surgery, according to a presentation at Hawaiian Eye 2022.
Julie Schallhorn, MD, MS, said monovision has been a staple in the treatment of presbyopia dating to the mid-1990s and provides good outcomes for patients.
“It’s got fairly high patient-reported satisfaction rates and fairly good function,” she said. “It remains very popular even to this day,”
According to the 2019 ASCRS Clinical Survey, an average of 12% of cataract cases are planned for “true” monovision rather than a presbyopia IOL procedure.
However, the benefits of monovision come with compromises, Schallhorn said.
“If you have monovision, you lose fusion, and you lose stereoacuity, particularly with patients with moderate to high amounts of anisometropia,” she said. “You’re losing something in a trade-off for that increase in your vision.”
Schallhorn said that studies have shown that the optimal amount of monovision is about 1.5 D. Keeping it at that level or lower allows patients to preserve fairly good stereoacuity. Monovision can provide better near vision with anisometropia but worse stereoacuity.
Schallhorn said other options, such as multifocal IOLs and extended depth of focus lenses, also provide benefits to patients. The choice comes down to matching the lens with the right patient.
“All of our current solutions come with a little bit of trade-off in terms of pros and cons,” she said. “Being familiar with them and with your patients’ goals will help you determine the right lens for them.”
Collapse
Schallhorn J. Monovision vs multifocal vs EDOF: Very important considerations. Presented at: Hawaiian Eye 2022; Jan. 15-21, 2022; Waikoloa, Hawaii.
Read more about
Click Here to Manage Email Alerts