Crossed versus conventional pseudophakic monovision for high myopic eyes: a prospective, randomized pilot study

Abstract

Background Aiming at spectacle independence, conventional pseudophakic monovision has been widely used in myopia patients with bilateral monofocal intraocular lens implantation. However, the crossed monovision, which is to correct the dominant eye for near vision and the non-dominant eye for distant vision, has been mentioned preferable for high myopic cataract patients by some studies. We have conducted this study to compare clinical results to assess the feasibility of conventional and crossed monovision for high myopic pseudophakic patients by comparing patient satisfaction, visual function and spectacle independence. Method Forty-sixth high myopia patients were divided into two groups: 22 in crossed monovision group with patients whose refraction targeted to − 2.00 diopters (D) in the dominant eye and − 0.50D in the non-dominant eye; 24 in conventional monovision group with patients whose refraction targeted to − 0.50D in the dominant eye and − 2.00D in the non-dominant eye. Binocular uncorrected distance visual acuity (BUDVA), binocular uncorrected near visual acuity (BUNVA), binocular corrected distant visual acuity (BCDVA), binocular corrected near visual acuity (BCNVA), contrast visual acuity and stereoacuity were examined at postoperative 2 weeks, 1 month and 3 months. Questionnaires were completed by patients 3 months after binocular surgery to evaluate patients’ satisfaction and spectacle independence. Results The conventional monovision and the crossed monovision group showed no significant differences of mean BUDVA, BUNVA, BCDVA, BCNVA 2 weeks, 1 month or 3 months postoperatively (P > 0.05). There was no difference in the bilateral contrast sensitivity or stereoscopic function between the convention conventional and crossed monovision groups (P > 0.05). Patient satisfaction with near and distant vision, as well as spectacle dependence did not differ significantly between the two groups (P > 0.05). Conclusion Crossed pseudophakic monovision exhibited similar visual function when compared with conventional monovision technique, which indicates that it is an effective option to improve the visual functionality and quality of life for high myopic patients who considering bilateral cataract surgery. Trial registration The Institutional Review Board and Ethics committee of the First Affiliated Hospital of Chongqing Medical University, Chongqing, China. The trial registration was submitted in September 2018 and passed on March 18, 2020, and the registration number is: ChiCTR2000030935.

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“…Xun et al . [31] conducted a randomized controlled trial that compared conventional monovision (24 patients) with crossed monovision (22 patients) in eyes with high myopia undergoing cataract extraction. The authors reported no significant difference between both methods in terms of visual acuity, contrast sensitivity, stereopsis, patient satisfaction or spectacle dependence [31].…”

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“…[3] In addition to affecting the quality of life, severe myopia can further develop into more severe diseases such as glaucoma and cataract, which may even lead to blindness. [4][5][6] Current treatments for myopia include pharmacotherapy, keratoplasty and laser corneal surgery. [7] However, the specific mechanisms of myopia development and myopia gene host reactions are still unclear.…”