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Monofocal plus - future or present?

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Kabiesz A., Grzbiela J., Skorupka D., Zemła P., Niewiem A.
OphthaTherapy
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2024
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vol. 11
|
issue 1
92-98
EN
The implantation of extended deep-of-focus intraocular lenses during cataract surgery allows patients to achieve spectacles independence. Correct calculation of the power of the lenses and the use of monovision significantly improves the level of satisfaction after the procedure. The choice of the target postoperative refraction of the dominant eye within the limits of emmetropia and the non-dominant eye with slight myopia within the range of -1.0 D can provide satisfactory visual acuity for a long distance, intermediate and near vision, without the need for glasses. Some authors classify some types of monofocal plus on an equal footing with lenses with an extended depth of focus. They are the latest solution in cataract surgery and are characterized by a low tendency to cause side effects typical of multifocal lenses.
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Monofocal plus lens - a perfect solution for (nearly) every patient? Surgeons' own experience with RayOne EMV

88%
Kaczmarek D. M., Kaczmarek R.
OphthaTherapy
|
2024
|
vol. 11
|
issue 3
299-306
EN
Objective: This article aims to briefly characterise the most popular IOLs on the market and focus on Rayner EMV: monofocal plus lens being a very good compromise between a good deal of spectacle independence, its price and coexisting ocular conditions allowing for its implantation. Setting the postoperative refraction at minimonovision as was done in this study allows for even greater depth of field and thus minimalizes the need for glasses when performing most everyday activities. Methods: To summarise the IOLs characteristics a literature search was conducted. In the second part of the article surgeons’ own experience is shown together with postoperative results and patients’ satisfaction survey. Results: Uncorrected binocular visual acuity was very high: 74% of patients reached 6/6 on Snellen chart or better, and for 96% of patients mean UCVA both eyes was 6/6.5 or better. Mean binocular UCVA both eyes was 6/5.5. Near visual acuity score: 43% of patients did not require spectacle correction for near reading and 91% of patients were able to read line D-0,75 or more on Snellen reading chart. Halo or glare effect were noted in 5 cases but only in two of them resulted in lower score in patients’ satisfaction questionnaire (to 64 and 79% of maximum score). In three remaining cases patients gave 95% of maximum score and stated that even though they noted halo and / or glare it did not comprise their visual quality. In patients’ satisfaction questionnaire score given by drivers was 90%; non-drivers were even more satisfied and gave 92% of maximum score – it shows very high percentage of satisfied patients in both groups. Conclusion: Rayner EMV IOL is an affordable and valuable option for patients who would like to increase their spectacle independence postoperatively and should be considered along with premium multifocal IOLs. Reducing spectacle dependence with the pseudophakic mini-monovision technique could improve the functionality, independence and quality of life for many patients.
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