Der Effekt der pseudophaken Minimonovision als Option einer Brillenunabhängigkeit im Alltag

Abstract

Das menschliche Auge eines Erwachsenen ist nahezu kugelförmig, misst im Durchmesser etwa 24 mm und wiegt etwa 7,5 g. Die Wand des Augapfels besteht außen aus der weißen, bindegewebigen Lederhaut (Sklera), die dem Augapfel die Form gibt und von der Bindehaut bedeckt wird, und der klaren Hornhaut (Kornea). Letztere weist eine stärkere Krümmung auf. g max = g + gw g min = g -gn Da die Gegenstandsweite mit der Lage des Fernpunktes gleichgesetzt wird, muss für jede Gegenstandsentfernung eine entsprechende Brennweite berücksichtigt werden.

Influence of the level of monovision on visual outcome with an extended range of vision intraocular lens

“…This high level of patient satisfaction is in agreement with the outcome reported in other studies evaluating the results of pseudophakic micro-monovision with monofocal IOLs. 10 , 11 , 15 Zettl et al 10 found a high patient satisfaction score of 93.18 in the VF-14 questionnaire after the implantation of monofocal IOLs generating an anisometropia between 0.5 and 1.75 D. Likewise, the level of patient satisfaction achieved in our study with the ERV IOL and a monovision of around 0.75 D is also consistent with that reported for different multifocal IOLs. 7 , 16 , 17 , 19 Mendicute et al 16 found that more than 90% of patients implanted with a trifocal diffractive IOL were satisfied with the visual outcome.…”

“…This option also provided high levels of spectacle independence at near (75.0% in group 4, 74.1% in group 5), which was better than spectacle independence levels reported for mini-monovision approaches with monofocal IOLs. 10 , 11 , 13 , 15 Likewise, this level of spectacle independence was equivalent to that found with some multifocal IOLs. 16 , 17 …”

“…This level of near visual outcome is better than that reported for pseudophakic mini-monovision correction with monofocal IOLs. 10 , 11 , 13 – 15 Our mini-monovision results were comparable to those with multifocal IOLs, but with a lower incidence of photic phenomena. 7 , 16 – 19 According to the results of our study, a monovision around 0.75 D seems to be the most recommendable option as it improved near vision without degradation of distance and intermediate vision.…”

“…With monofocal IOLs, a monovision around 0.75 D was shown to induce good distance (100% achieving at least 0.0 logMAR binocular UDVA) and intermediate visual outcome (100% achieving at least 0.1 logMAR binocular UIVA), and a relatively functional near vision (63.33% achieving 0.3 logMAR binocular UNVA). 10 Less dependence on glasses has been reported for multifocal IOLs compared to pseudophakic monovision, but with significantly more photic phenomena and an increased risk for IOL explantation due to patient dissatisfaction. 11 – 15 Hence, monovision using monofocal IOLs with modest refractive differences between eyes is able to provide functional vision and good patient satisfaction without the inherent risk for troublesome visual symptoms associated with multifocal IOLs.…”

“… 11 – 15 Hence, monovision using monofocal IOLs with modest refractive differences between eyes is able to provide functional vision and good patient satisfaction without the inherent risk for troublesome visual symptoms associated with multifocal IOLs. 10 – 15 Our hypothesis was that the use of an ERV IOL with a mini-monovision approach may be an effective option for a complete visual rehabilitation, as ERV IOLs provide excellent distance and intermediate visual outcomes and the minimal limitation for near vision may be overcome with the induced slight monovision.…”