Subjective evaluation of uncorrected vision in patients undergoing cataract surgery with (diffractive) multifocal lenses and monovision

Introduction: Cataract surgery is currently considered to be a refractive procedure, as in addition to restoring vision, it provides the patient with greater independence from glasses. Multifocal intraocular lenses (IOLs) represent a major breakthrough in quality of life and visual expectations, especially with regard to independence from glasses. Evaluation studies of patient satisfaction regarding distance and near vision have shown high levels of satisfaction after the implantation of multifocal lenses.1–3 Despite the benefits of corrected visual acuity at multiple distances, multifocal lenses are associated with certain disadvantages, with halos and glares being the most frequent complaints.4 Furthermore, most of these lens modes are not available to all patients due to their high costs.5 Monovision is a technique that became common after the emergence of refractive surgery in which one eye, usually the dominant one, is focused for distance vision and the other for near vision.6 This mode eliminates or significantly reduces dependence on glasses and contact lenses for most daily activities and is slightly better than the multifocal IOLs in terms of intermediate vision. In addition, it costs much less and is a good alternative for some patients. Retrospective studies of monovision have revealed a success rate of 73%.7 However, one concern is the loss of binocularity, which does not commonly occur when using multifocal IOLs.8

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