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

Tanvi Suhas Haldipurkar, Suhas Haldipurkar, Devendra Venkatramani, Ruta Walavalkar, Sarita Deshpande, Maninder Singh Setia Laxmi Eye Institute and Laxmi Charitable Trust, Panvel, IndiaCorrespondence: Maninder Singh Setia, Laxmi Eye Institute and Laxmi Charitable Trust, Panvel, Maharashtra, 410206, India, Email [email protected]: 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 − 0.75 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.Keywords: intermediate vision, monofocal IOLs, mini monovision