Comparison of visual performance and satisfaction with a bilateral emmetropic vs a bilateral mild myopic target using a spherical monofocal intraocular lens

J Cataract Refract Surg. 2020 Jun;46(6):839-843. doi: 10.1097/j.jcrs.0000000000000183.

Abstract

Purpose: To compare the binocular visual outcomes and satisfaction of patients with emmetropia or mild myopia (-0.50 diopters [D]) implanted with a bilateral spherical monofocal IOL.

Setting: Ophthalmology Department, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.

Design: Prospective nonrandomized study.

Methods: This study comprised 2 groups of 30 patients each. Group 1 included patients implanted with bilateral monofocal IOLs with near emmetropic target (plano to -0.25 D). Group 2 included patients with a postoperative bilateral target of -0.50 D. Both groups underwent uncorrected and corrected distance defocus curves postoperatively and subjective questionnaires were used to investigate patient satisfaction postoperatively.

Results: The defocus curve showed a significant difference between Group 1 and Group 2 binocular vision (all P values <.01 except at -3.00 D where P value = .32) with Group 1 seeing significantly better than Group 2 at +1.00, +0.50, and 0 but significantly worse in all other points of the defocus. In addition, patients of Group 2 at 0 D of defocus curve (infinite) had a visual acuity close to 0 logarithm of the minimum angle of resolution (logMAR) (0.03 ± 0.04). The main outcome of Group 2 defocus curves was that, at defocus point 0 D, even if the mean refraction was -0.67 0.15 × 160, mean uncorrected logMAR visual acuity was 0.0 ± 0.06.

Conclusions: Bilateral monofocal IOLs implanted with mild myopic target provided better intermediate visual acuity compared with emmetropia at a minimal cost in terms of uncorrected distance visual acuity.

MeSH terms

  • Emmetropia
  • Humans
  • Italy
  • Lens Implantation, Intraocular
  • Lenses, Intraocular*
  • Myopia* / surgery
  • Patient Satisfaction
  • Personal Satisfaction
  • Phacoemulsification*
  • Prospective Studies
  • Prosthesis Design
  • Refraction, Ocular
  • Vision, Binocular