Visual and Refractive Outcomes and Patient Satisfaction Following Implantation of Monofocal IOL in One Eye and ERV IOL in the Contralateral Eye with Mini-Monovision

Ocular dominance shift in refractive cataract surgery: prospective, observational study

PURPOSE

To explore the features of the dominant and nondominant eyes in patients with cataracts and predict ocular dominance shift (ODS) based on preoperative indicators.

SETTING

Changsha Aier Eye Hospital, Changsha, Hunan, China.

DESIGN

Prospective, observational study.

METHODS

Patients with age-related cataracts who underwent unilateral cataract surgery were enrolled in this study. Before the procedure, uncorrected distance visual acuity (UDVA) was assessed and noncycloplegic subjective refraction evaluations were conducted to determine corrected distance visual acuity. Total astigmatism, corneal astigmatism, and intraocular astigmatism were measured using OPD-Scan III. Cataract type was assessed using slitlamp biomicroscopy based on the Lens Opacities Classification System III. Ocular dominance (OD) was determined under corrected conditions using the hole-in-card test. Follow-up visits occurred at 1 day, 1 week, and 1 month postoperatively. After 1 month, OD was re-evaluated, and participants completed the 9-item Short-Form Cataract Questionnaire.

RESULTS

94 patients (188 eyes) were enrolled in the study. The analysis showed that the ODS rate of unilateral cataract surgery was 40.4%. In addition, age, UDVA of the nondominant eye, posterior subcapsular cataract, and total astigmatism were risk factors for ODS. No difference in vision-related quality of life was detected between patients who had ODS and those who did not.

CONCLUSIONS

Several preoperative parameters as potential risk factors of ODS after cataract surgery were identified. These findings provide guidance for predicting changes in the dominant eye and may improve the precise selection of intraocular lenses and implementation of monovision strategies.

Reading Performance Following Contralateral Implantation of an Extended Depth of Focus (EDOF) IOL and a Hybrid EDOF Multifocal IOL

PURPOSE

To assess objective reading performance at intermediate and near distances using the Salzberg Reading Desk (SRD) (SRD Vision) in patients with cataract who underwent the implantation of a diffractive extended depth of focus intraocular lens (EDOF IOL) in the dominant eye and a hybrid multifocal EDOF IOL in the non-dominant eye.

METHODS

This prospective, non-comparative, interventional study included 46 eyes of 23 patients with cataract who underwent bilateral cataract surgery with implantation of the DFR00V Tecnis Synergy IOL (Johnson & Johnson Surgical Vision) in the non-dominant eye and the DXR00V Tecnis Symfony OptiBlue IOL (Johnson & Johnson Surgical Vision) in the dominant eye. At postoperative 6 months, the Salzburg Reading Desk was used to assess distance-corrected reading performance at near and intermediate distances.

RESULTS

Although the monocular reading acuity at the preferred intermediate distance was statistically significantly better in the eyes implanted with the DXR00V IOL, it was better with the DFR00V IOL at preferred near distances. The mean binocular distance-corrected preferred intermediate and near reading acuity was 0.07 ± 0.09 (20/23) and 0.13 ± 0.09 (20/27) logarithm of the minimum angle of resolution, respectively. Other parameters of reading performance, such as reading speed, reading distance, reading time, and smallest scale log print size, were similar between the two IOL groups when assessed monocularly.

CONCLUSIONS

Implanting a DFR00V IOL in the non-dominant eye and a diffractive DXR00V IOL in the dominant eye resulted in excellent binocular reading acuity and speed at intermediate and near distances. [J Refract Surg. 2024;40(11):e778-e782.].

Factors influencing dominant eye selection in refractive surgery patients: A correlation analysis

OBJECTIVE

This study aims to reveal the factors influencing the selection of the dominant eye in refractive surgery patients, and enhance the accuracy of clinical evaluation and surgical treatment.

METHODS

A retrospective study method was employed. The ocular biometric parameters were analyzed in 4,114 patients who underwent refractive surgery at the affiliated hospital of Southwest Medical University from 2019 to 2023.

RESULTS

The study found that 79.07% of the patients had the right eye as the dominant eye, while 20.93% had the left eye. Although there was no significant difference between the dominant and non-dominant eyes in terms of uncorrected visual acuity and Kappa angle, the dominant eye performed better in aspects such as spherical lens, eye axis, and corneal flat curvature. Furthermore, univariate and multivariate logistic regression results showed that best-corrected visual acuity, pupil diameter, horizontal displacement x-value of the Kappa angle, and astigmatism vector J45 were significant influencing factors for the selection of the dominant eye.

CONCLUSION

There are numerous factors affecting the dominant eye, and the most important core factor is J45. This study comprehensively evaluated the possible factors affecting the dominant eye in patients undergoing refractive surgery, which provides a foundation for the designation of refractive surgical modalities and assurance of surgical outcomes, and opens up new perspectives on understanding the mechanisms of the formation and development of the dominant eye.

Ocular dominance in cataract surgery: research status and progress

Ocular dominance (OD), a commonly used concept in clinical practice, plays an important role in optometry and refractive surgery. With the development of refractive cataract surgery, the refractive function of the intraocular lens determines the achievement of the postoperative full range of vision based on the retinal defocus blur suppression and binocular monovision principle. Therefore, OD plays an important role in cataract surgery. OD is related to the visual formation of the cerebral cortex, and its plasticity suggests that visual experience can influence the visual system. Cataract surgery changes the visual experience and transforms the dominant eye, which confirms the plasticity of the visual system. Based on the concept and mechanism of OD, this review summarizes the application of OD in cataract surgery.