IRIS® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation

Shamik Bafna; Xiaolin Gu; Helene Fevrier; Mohinder Merchea

doi:10.2147/OPTH.S424195

IRIS^® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation

Clin Ophthalmol. 2023 Oct 19:17:3123-3129. doi: 10.2147/OPTH.S424195. eCollection 2023.

Authors

Shamik Bafna¹, Xiaolin Gu², Helene Fevrier³, Mohinder Merchea²

Affiliations

¹ Cleveland Eye Clinic, Brecksville, OH, USA.
² Alcon Vision LLC, Fort Worth, TX, USA.
³ Verana Health, San Francisco, CA, USA.

Abstract

Purpose: To determine the incidence of pseudophakic monovision among patients bilaterally implanted with monofocal intraocular lenses (IOLs) and to characterize the distribution of myopic offsets achieved.

Patients and methods: This retrospective database study included data on patients receiving care from ophthalmologists who contributed to the Academy IRIS^® (Intelligent Research In Sight) Registry. Anonymized data were collected, including patient age, ethnicity, procedure data (CPT code, date, laterality), and postoperative manifest refractive spherical equivalent (MRSE) in both eyes implanted with monofocal or monofocal toric IOLs. No data regarding IOL manufacturer, model, or power were collected. One primary outcome measure was the percentage of patients achieving monovision (defined as emmetropia within ±0.25 diopters [D] in one eye and a myopic offset of ≥0.50 D in the fellow eye) among all patients receiving bilateral monofocal IOLs at the time of cataract surgery between January 1, 2016, and September 1, 2019, with at least 90 days of follow-up. Other primary outcomes included the distribution and frequency of myopic offsets (anisometropia) between eyes.

Results: Of the 16,765 people receiving bilateral monofocal IOLs within the study period, 4796 (28.6%) achieved emmetropia in at least one eye, as defined by an MRSE within ± 0.25 D. The incidence of monovision among these patients was 34.2% (1638/4796). One-quarter (24.7%; 405/1638) of patients who achieved monovision had a myopic offset between 0.50 and 0.74 D, with more than one-third (35.2%; 576/1638) falling within 0.75-1.24 D and 18.0% within 1.25-1.74 D. A myopic offset ≥1.75 D was observed in 22.1% (362/1638) of patients who achieved monovision.

Conclusion: Pseudophakic monovision for presbyopia correction was achieved in ~34% of patients in the IRIS Registry bilaterally implanted with monofocal IOLs, with myopic offsets typically ranging from 0.5 to 1.24 D.

Keywords: diopter correction; monofocal IOLs; monovision; myopic offset; presbyopia.