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REVIEW article

Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1522383
This article is part of the Research Topic Enhancing Patient Outcomes After Cataract, Corneal and Refractive Surgery View all 9 articles

Outcomes of mini-monovision with monofocal, enhanced monofocal and extended depth-of-focus intraocular lenses

Provisionally accepted
Issac Levy Issac Levy 1,2,3Rachana Shah Rachana Shah 1Ritika Mukhija Ritika Mukhija 1Mayank A Nanavaty Mayank A Nanavaty 1,4*
  • 1 University Hospitals Sussex NHS Foundation Trust, Chichester, United Kingdom
  • 2 Rabin Medical Center, Petah-Tikva, Israel
  • 3 School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 4 Brighton and Sussex Medical School, Brighton, England, United Kingdom

The final, formatted version of the article will be published soon.

    Mini-monovision is a vision correction technique that allows for a broader spectrum of spectacle independence while minimizing anisometropia. This systemic review aims to evaluate the clinical outcomes of pseudophakic mini-monovision with three types of intraocular lenses (IOLs): monofocal, enhanced monofocal, and extended depth of focus (EDOF). Methods: A comprehensive literature search was conducted using PubMed and MEDLINE to identify studies reporting mini-monovision outcomes within the three categories of IOLs up to July 2024. Inclusion criteria were studies with more than 20 patients, target refraction to achieve mini-monovision difference in the fellow eye, and minimum follow-up of 3 months. The primary outcome measure was uncorrected binocular intermediate visual acuity (UCIVA). The secondary outcomes were binocular uncorrected distance visual acuity (UCDVA), binocular uncorrected near visual acuity (UCNVA), patient-reported outcomes measures (PROMs), spectacle independence, contrast sensitivity, photic phenomenon, enhancement surgeries and IOL exchange. Results: 113 studies were screened, of which 19, with a total of 1530 patients, were eligible for inclusion in this review. Mean logMAR binocular UCIVA was 0.16±0.01, 0.11±0.06, 0.08±0.07 (p=0.41), and mean logMAR UCDVA was 0.08±0.05, 0.04±07, 0.04±0.04 (p=0.36), in the monofocal, enhanced monofocal, and EDOF groups, respectively. The mean spectacle independence rate was 51%±22.1, 55%±35.4 and 63.4%±24.6 (p=0.05), respectively, in the monofocal, enhanced monofocal and EDOF groups. A comparable low incidence of halos and glare was observed when enhanced monofocal lenses. EDOF lenses have, however, demonstrated mixed results. The complications, IOL exchange, and excimer laser enhancement rates were low across all groups . Conclusions: While enhanced monofocal and EDOF IOLs may provide slightly better binocular intermediate visual outcomes and higher spectacle independence compared to monofocal lenses with regards to mini-monovision and intermediate vision performance, the differences are not statistically significant. All three IOL types exhibit high patient satisfaction rates when choosing a mini-monovision approach with decreased dependence on spectacles.

    Keywords: minimonovision, enhanced monofocal intraocular lenses, extended depth of focus intraocular lens, Monofocal intraocular lens, Intermediate visual acuity

    Received: 04 Nov 2024; Accepted: 17 Jan 2025.

    Copyright: © 2025 Levy, Shah, Mukhija and Nanavaty. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mayank A Nanavaty, University Hospitals Sussex NHS Foundation Trust, Chichester, BN11 2DH, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.