• Int. J. Clin. Pract. · Oct 2020

    Cataract surgery in Kinshasa - Is there a place for "Monovision"?

    • Thomas Stahnke, Edith Mukwanseke, Ngoy J Kilangalanga, Adrian Hopkins, Oliver Stachs, and Rudolf F Guthoff.
    • Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.
    • Int. J. Clin. Pract. 2020 Oct 1; 74 (10): e13588.

    ObjectivesMonovision is a method of correcting presbyopia where one eye is focused for far and the other for near vision. It is a simple, cost-effective approach to overcome the loss of accommodation with age and to become spectacles independent.MethodologyAbout 50 patients, where bilateral cataract extraction was indicated, were included in this study performed at the St. Joseph's Eye Hospital in Kinshasa (DR Congo). Small incision cataract surgery technique (SICS) was applied with the implantation of 6 mm PMMA lenses in the capsular bag. IOL refractive power choice was made to achieve a post-operative refraction of -0.5 dpt for the eye selected for far vision. The second eye received an implant heading for a post-operative myopia of -1.5 dpt suitable for intermediated and near vision. According to the literature, monovision criteria have been regarded as fulfilled when (a) far vision was 0.5 (logMAR) or better and (b) near vision was P3 (0.40, Decimal 32 cm) or better. Spectacle dependence after bilateral cataract surgery heading for monovision was analysed using a dedicated questionnaire.ResultsOut of all 50 patients 22 (44%) fulfilled the above defined criteria of monovision in terms of post-operative refraction and visual acuity. About 19 out of these 22 (86.3%) patients were happy without glasses. Two of them used bifocal spectacles, whereas the remaining patient refused spectacles. About 28 patients did not fulfill monovision criteria. Out of these 28 patients, however, 9 (32.1%) of them are happy without glasses.ConclusionIn view of the described local circumstances aiming for monovision after bilateral cataract surgery is a suitable approach to optimise cataract surgical outcomes with no extra costs for surgery but considerable improvement of patient's visual performance in daily life.© 2020 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd.

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