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58 | EYEWORLD | MARCH 2020 R EFRACTIVE For patients who want the best quality of vision possible and who don't mind wearing reading glasses, Dr. Donnenfeld still thinks that traditional monovision IOL techniques do well. But there is a downside to the –1.50 difference between the eyes when using this approach. "The problem is that their distance vision is so compromised by the monovision that they lose the depth of focus," Dr. Donnenfeld said. "They lose a lot of quality of vision and have a lot harder time judging distance in front of them." He views the mini-monovision approach as much safer. Other combinations with the EDOF lens are being studied. "Kerry Solomon, MD, recent- ly presented a paper looking at the EDOF lens in the dominant eye and a +3.25 multifocal lens in the nondominant eye, and there were good results with that," Dr. Donnenfeld said. comfortable that the patient is going to be happy with the distance vision. For the non- dominant eye, he then decides whether to give the patient the same lens or try something else. "If they're not happy, I have the opportunity to either do mini-monovision like we did in the study or add a higher multifocal in the nondom- inant eye," he said, adding that both techniques work effectively. Dr. Donnenfeld always talks to presbyopic patients about the quality of vision that they can expect with EDOF lenses, if they are candi- dates. "I tell them that the quality of vision with an EDOF lens is comparable to a monofocal lens," he said. Such lenses have negative spher- ical aberration to correct the natural spherical aberration. Also, this lens is a diffractive one, both at near and at distance, unlike other lenses that are only diffractive at near. "Because it's a diffractive lens at distance, it corrects chromatic aberrations as well as spherical aberration," Dr. Donnenfeld said. continued from page 56 EXPERIENCE EYEWORLD 24/7 EyeWorld.org • Recent articles in web-friendly format • Searchable archives from 2007 to present • EyeWorld Weekly news feed • Trending videos • Live Twitter feed • Supplements

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