Comparison of Visual Performance and Satisfaction with a Bilateral Emmetropic vs a Bilateral Mild Myopic Target using a Spherical Monofocal Intraocular Lens.

PURPOSE: To compare the binocular visual outcomes and satisfaction of patients with emmetropia or mild myopia (-0.50 diopters [D]) implanted with a bilateral spherical monofocal intraocular lens (IOL). SETTING: Ophthalmology Department, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. DESIGN: Prospective nonrandomized study. METHODS: This study comprised 2 groups of 30 patients each. Group 1 included patients implanted with bilateral monofocal IOLs with near emmetropic target (plano to -0.25 D). Group 2 included patients with a postoperative bilateral target of -0.50 D. Both groups underwent uncorrected and corrected distance defocus curves postoperatively and subjective questionnaires were used to investigate patient satisfaction after surgery. RESULTS: The defocus curve showed a significant difference between Group 1 and Group 2 binocular vision (all p values <0.01 except at -3.00 D where p value=0.32) with Group 1 seeing significantly better than Group 2 at +1.00, +0.50 and 0 but significantly worse in all other points of the defocus. In addition, patients of Group 2 at 0 D of defocus curve (infinite) had a visual acuity close to 0 logarithm of the minimum angle of resolution (logMAR) (0.03+/-0.04). The main outcome of Group 2 defocus curves was that, at defocus point 0 D, even if the mean refraction was -0.67 0.15 x 160, mean unaided logMAR visual acuity was 0.0+/-0.06. CONCLUSIONS: Bilateral monofocal IOLs implanted with mild myopic target provided better intermediate visual acuity compared to emmetropia at a minimal cost in terms of unaided distance visual acuity.