EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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EW RESIDENTS 56 August 2014 stereopsis as a reason. 58.3% of these 12 subjects reported asthenopia as the reason for their dissatisfaction, but it is unclear if the asthenopia was due to decreased stereopsis. There was no demonstration of the connection between subjects' degree of exophoria and report of astheno- pia. As reviewers and as developing cataract surgeons, we would have appreciated the identification of factors that would help determine which patients are likely to be less than satisfied with pseudophakic monovision; the clinical relevance of pre- or postoperative degrees of exophoria and fusional abilities re- mains unclear. Perhaps preoperative exophoria or decreased stereopsis could actually be correlated with increased satisfaction after pseu- dophakic monovision correction, as patients may have increased ability for the eyes to work independently. Conclusion While the potential of preoperative- ly examining the degree of exopho- ria to aid in determining whether or not a patient should receive pseu- dophakic monovision is appealing, the article "Binocular function in patients with pseudophakic mono- vision" did not adequately prove this connection. Although flaws in the study design may have limited the authors' conclusions, we are very grateful to the authors for insightfully discussing what could be an important concept in surgical decision-making. EW References 1. Ito M, Shimizu K, Niida T, Amano R. Binocular function in patients with pseudophakic monovision. J Cataract Refract Surg (Aug.) 2014;40:1349–1354. 2. Finkelman YM, Ng JQ, Barrett GD. Patient satisfaction and visual function after pseu- dophakic monovision. J Cataract Refract Surg. 2009;35(6):998–1002. 3. Greenbaum S. Monovision pseudophakia. J Cataract Refract Surg. 2002;28(8): 1439–43. 4. Ito M, Shimizu K, Amano R, Handa T. Assessment of visual performance in pseudophakic monovision. J Cataract Refract Surg. 2009;35(4):710–4. Contact information Oetting: thomas-oetting@uiowa.edu demonstrated by a previous paper from the same author. Ito et al cited their previous work "Assessment of visual performance in pseudophakic monovision," 4 when stating that, "Although more than 80% of the 82 patients in our previous pseudopha- kic monovision study were satis- fied with the outcomes, a relative decrease in stereopsis was noted." However, on careful inspection of that article, only two subjects (2.4%) in that study were "dissatisfied" with their outcome; 85.4% and 12.2% of subjects had satisfaction degrees of "satisfied" and "acceptable," respec- tively. Furthermore, there was no report as to why those two subjects were dissatisfied and if it was related to decreased stereopsis. Addition- ally, the authors did not report the degree of stereopsis in patients who were satisfied with their outcome. The authors did evaluate why sub- jects found their surgical outcome to be only "acceptable" or "dissatis- fied" (n=12), but either the authors did not ask or the patients did not report complaints of decreased Back row: Jon Hager, MD, Justin Risma, MD, Matt Weed, MD, Jesse Vislisel, MD, Jeff Welder, MD, A. Tim Johnson, MD, Blake Perry, MD, David Phillips, MD Front row: Phil Niles, MD, Brad Sacher, MD, Johanna Beebe, MD, Pavlina Kemp, MD Source: University of Iowa Difficulty continued from page 55