Bilateral cataract monovision surgery in a 54-year-old woman following Presbyond laser-blended vision: A case report

This case report describes the feasibility of achieving spectacle independence after cataract surgery in a patient who has undergone Presbyond laser-blended vision (LBV) for presbyopia correction 5 years back. A 54-year-old woman presented with a gradual diminution of vision in both eyes for 2 years. On examination, unaided distance visual acuity (UDVA) was 20/40 in oculus uterque (OU), and corrected distance visual acuity (CDVA) was 20/40, N5 binocularly. The primary diagnosis was posterior subcapsular cataract with nuclear sclerosis grade 1 with status post-Presbyond LBV. Cataract surgery with aspheric monofocal intraocular lens (IOL) and monovision by targeting dominant oculus dexter (OD) to emmetropia and non-dominant oculus sinister (OS) to myopia of –1.5 D was planned for the patient. Multiple formulae were used to calculate the IOL power and it was decided to implant + 24.0 D in OD and + 22.5 D in OS calculated using Barrett’s True K TK/TK universal II formula. On post-operative day 15, no complications were noted, UDVA in OD was 20/20 and in OS was 20/125 and CDVA was 20/20 in OS. Uncorrected near visual acuity was N10 in OD and N5 in OS, with a refraction of –1.75DS/–0.50DC @15 degrees in OS (Monovision) which was stable even at 6 months follow-up. The patient achieved good distance, intermediate and near vision due to the pre-existing corneal spherical aberrations induced by Presbyond. The choice of aspheric IOL with appropriate power prevented change in the total spherical aberrations and helped to achieve spectacle independence in this patient.