Evaluation of Intermediate Visual Outcomes in Eyes Implanted with Bilateral Advanced Monofocal Intraocular Lens Targeting for Mini-Monovision and Its Association with Age and Corneal Asphericity.

Purpose: To assess the visual outcomes in patients bilaterally implanted with novel Clareon intraocular lens when targeting mini monovision post-operatively.

Setting: The study was conducted at Laxmi Eye Institute; it is a tertiary care eye institution in Panvel, India.

Design: This is an investigator initiated, prospective, single-centre longitudinal study of 45 patients to assess the visual outcomes in patients who were implanted with Clareon IOL bilaterally.

Methods: Patients with corneal astigmatism of ≤0.75 D who underwent bilateral cataract surgery with pseudophakic mini-monovision and implanted with novel Clareon intraocular lens were included. Patients having post op manifest refraction >±0.25 D in the dominant eye and <-0.5 D or >-0.75 D in the non-dominant eye were excluded. The main study outcomes were assessed at 1 and 3 months; it included uncorrected visual acuities assessment, defocus curve, and patient reported spectacle use.

Results: The mean (SD) binocular distance corrected intermediate visual acuity at 3 months was 0.22 (0.09) LogMAR. At 3 months, 54% of patients enjoyed 0.4 LogMAR or better BUCNVA. The defocus curve showed good distance and intermediate visual acuity with >0.2 LogMAR vision from +0.50 D to -1.50 D. We found a positive correlation between the Q value of the dominant eye and the BCIVA at 3 months postoperatively, however it was not statistically significant. The Q value was more negative when the intermediate vision was closer to 0 LogMAR. Post operatively, at 3 months, 95% patients did not need glasses for distance and intermediate vision and 73% of patients were comfortable for intermediate vision without glasses all the time.

Conclusion: Mini-monovision with Clareon monofocal IOL implantation can offer overall satisfactory vision for far and intermediate distances with minimal need for use of spectacles for near vision.