Pseudophakic mini-monovision

Abstract

Cataracts and presbyopia represent leading global causes of visual impairment, and demand for spectacle independence after cataract surgery continues to rise. Pseudophakic mini-monovision, a refined adaptation of traditional monovision employing milder anisometropia (-0.75 to -1.50 diopter), has emerged as an effective and versatile strategy to address this need. Compared with conventional monovision, mini-monovision better preserves stereopsis and binocular vision while providing satisfaction and spectacle independence approaching that of multifocal intraocular lenses (IOLs). Success is influenced by factors such as neuroadaptive capacity, ocular dominance, pupil size, and precision of refractive targeting. Advances in IOL technologies, including enhanced monofocal, extended depth of focus, and light-adjustable lenses, have further expanded mini-monovision's applicability, offering customizable visual outcomes. Careful preoperative evaluation and accurate biometry remain critical to screening candidates and optimizing refractive accuracy. Alternative designs, including crossed and hybrid monovision, extend its clinical versatility. By integrating with modern IOL innovations, mini-monovision provides a cost-conscious, patient-centered approach that balances spectacle independence with visual quality, reinforcing its relevance in personalized refractive cataract surgery.

Keywords: Anisometropia; Cataract surgery; Intraocular lens; Mini-monovision; Presbyopia; Refractive lens exchange.