Pseudophakic monovision using monofocal and multifocal intraocular lenses: hybrid monovision

Abstract

Purpose: To evaluate the visual function after bilateral cataract surgery performed with a new technique (hybrid monovision) that uses a monofocal intraocular lens (IOL) and a diffractive multifocal IOL.

Setting: Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan.

Design: Case series.

Methods: Hybrid monovision was achieved by implanting a monofocal IOL (AQ310Ai) in the dominant eye and a diffractive multifocal IOL (Tecnis ZM900) in the nondominant contralateral eye. The target refraction was emmetropia in both eyes. Visual acuity at various distances, contrast sensitivity, near stereopsis, reading ability, and the degree of patient satisfaction were measured.

Results: The study enrolled 32 patients with a mean age of 61.2 years ± 14.7 (SD). At all distances, the mean binocular visual acuity was better than 0.1 logMAR. Binocular contrast sensitivity was better than monocular vision in the eye with the diffractive multifocal IOL. Near stereopsis within normal range was maintained in 62.5% of patients. Of the patients, 18.8% reported spectacle dependence. With binocular vision, no patients reported waxy vision (ie, as though they were looking through water).

Conclusion: Hybrid monovision may be an effective approach for managing loss of accommodation after cataract surgery and may be the method of choice in cases of waxy vision caused by bilateral multifocal IOL implantation.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.