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Blended Monovision Cataract Surgery

Blended Monovision Cataract Surgery

Posted on August 31, 2023
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Blended Monovision Cataract Surgery

Many people are looking for blended monovision cataract surgery, especially if they have hyperopia. Traditionally, monovision involved creating a significant difference in prescription between the two eyes, typically achieved using contact lenses. However, advancements in IOL technologies have led to a shift in terminology from “monovision” to “blended vision.

As advancements in Intraocular Lens (IOL) technologies continue to reshape possibilities, the landscape of monovision is undergoing a transformative shift. The term “blended vision” is emerging as a more encompassing and precise way to describe these refined strategies, offering patients not only functional vision but a harmonious synergy between their eyes. In this exploration, we delve into the nuances of this evolving narrative, unraveling the intricacies of blended vision, the pioneering approaches adopted by leading ophthalmologists, patient considerations, and the promising horizon where technology and patient needs converge.

Innovations in IOL Technology

The landscape of monovision is being transformed by Intraocular Lens technologies, fundamentally changing distance vision in the dominant eye and enabling functional near vision in the non-dominant eye post-cataract surgery. This approach, known as “blended vision,” offers a more coordinated visual experience compared to traditional monovision.

The Transition to Blended Monovision Cataract Surgery

Traditionally, monovision involved creating a significant difference in prescription between the two eyes, typically achieved using contact lenses. However, advancements in IOL technologies have led to a shift in terminology from “monovision” to “blended vision.” This “blended vision” offers a more harmonious experience, where the eyes work together seamlessly. With technologies like the IC-8 Apthera IOL from AcuFocus, patients experience a significantly improved visual outcome compared to conventional monovision methods.

Approaches to Monovision

Some ophthalmologists have embraced monovision as a common strategy for cataract patients. They adopt a micro-monovision approach, providing a slight difference in prescription (around 0.75–1 D) between the eyes to ensure comfortable near vision without compromising distance sight. The integration of Extended Depth of Focus (EDOF) lenses with monovision has been a notable advancement, enhancing patient outcomes. Noteworthy IOLs like Eyhance (Johnson & Johnson Vision), RayOne EMV (Rayner), and Vivity (Alcon) are often used.

Refining the Approach in Blended Monovision Cataract Surgery

Thanks to EDOF technology, even a slight hyperopic shift does not hinder patients’ distance vision. The IC-8 Apthera IOL stands out as it provides up to 1.5 D of near vision while maintaining excellent distance vision, making it suitable for post-refractive cornea patients seeking spectacle independence.

Variations in Implementation

An ophthalmologist can employ multiple strategies for achieving monovision. They can offer monofocal or monofocal toric lenses, the Vivity IOL, and the Light Adjustable Lens (LAL) from RxSight. By discussing the benefits and ranges of these options, a tailored solution can be provided. The LAL is especially useful for patients who have undergone prior corneal refractive surgery, ensuring precise vision correction.

Patient Assessment in Blended Monovision Cataract Surgery

Patient suitability is key in monovision. Residual issues can be resolved with glasses, making monovision a preferable choice for many. Patients with amblyopia, macular degeneration, or significant pathology affecting one eye are not ideal candidates. Suggesting monovision for patients who have previously enjoyed the technique and who aren’t suitable candidates for multifocal lenses. Additionally, athletes requiring depth perception, like golfers, may not find monovision suitable due to its potential impact on certain activities.

Patient Selection

Careful patient selection is essential for successful blended vision outcomes. Conditions like strabismus or keratoconus, along with compromised eyes, may not tolerate the independent functioning required for blended vision. Some patients might not adapt well to monovision; for them, bilateral multifocal IOLs offer an alternative.

A Promising Future:

With the ongoing refinement of ophthalmological approaches and the continuous evolution of IOL technologies, the prospects for blended vision are undeniably bright. This convergence of cutting-edge IOLs and individualized patient factors points towards a future where visual challenges are relegated to history, symbolizing a profound shift in how we understand and enhance human vision.

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