Eyeworld

56 | EYEWORLD | MARCH 2020 R EFRACTIVE by Maxine Lipner Senior Contributing Writer vision group had a mean refractive residual astigmatism of 0.5 D or lower, as did 95% of those targeted for emmetropia. At 4 m, those in the mini-monovision group had slightly worse uncorrected visual acuity in the one eye than those in the emmetropia group. However, with binocular uncorrected acuity, there was not a statistically significant difference, Dr. Don- nenfeld said. Meanwhile, at 40 cm the residual refractive error was 0.25 D for those in the mini-monovision group versus 0.34 D in the emmetropia group. "Patients got very good distance but also got significantly better read- ing by adding that 0.5 D of monovision in the nondominant eye," he said. Dr. Donnenfeld actually changed his ap- proach to presbyopia management with EDOF lenses because quality of vision has improved with this technology. Previously, he used to put the lens in the nondominant eye first to make sure that the patient would tolerate the distance vision, then based on this experience, he would decide what to put in the other eye. Now, most of the time, Dr. Donnenfeld said he puts the EDOF lens in the dominant eye first and is O ne of the downsides of extended depth of focus (EDOF) IOLs is that they don't give completely spectacle-free near vision, but research has found a way around this. By using a slight monovision (nanovision), the distance and intermediate vision of EDOF lenses is main- tained, while near vision is improved. 1 "The advantage of these lenses is that they provide, in my estimation, the best quality of vision at distance of any presbyopic IOL that gives mid-range or near vision," said Eric Donnenfeld, MD. Dr. Donnenfeld and co-investigators re- searched the use of EDOF lenses where 0.5 D of monovision was left in the nondominant eye with the Tecnis Symfony Toric IOL (Johnson & Johnson Vision). "You get all the advantage of the Symfony lens at distance in the dominant eye, while you're still getting 20/25 vision, and you're getting the extra diopter of reading in the nondominant eye," Dr. Donnenfeld said of this technique. Outcomes in this prospective case series indicated that 92% of eyes in the mini-mono- Outcomes with EDOF mini-monovision About the doctor Eric Donnenfeld, MD Ophthalmic Consultants of Long Island Garden City, New York Reference 1. Sandoval HP, et al. Extended depth-of-focus toric intraocu- lar lens targeted for binocular emmetropia or slight myopia in the nondominant eye: Visual and refractive clinical out- comes. J Cataract Refract Surg. 2019;45:1398–1403. Relevant disclosures Donnenfeld: Johnson & Johnson Vision continued on page 58 Symfony IOL in place showing diffractive rings Symfony Toric IOL in place with positioning markers at 180 degrees Source (all): Eric Donnenfeld, MD Contact Donnenfeld: ericdonnenfeld@gmail.com RESEARCH HIGHLIGHT

• Blank Page
• Blank Page (1)