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Comments Modified monovision or "mini-monovision," which requires a smaller interocular diopteric power difference between eyes than traditional monovision, appears to be a safe and effective treatment for presbyopia. With the use of aspheric monofocal equiconvex IOLs to achieve "blended vision," not only are the photopic phenomena associated with multifocal IOLs minimized, but a larger number of patients can be considered as potential candidates.
A smaller difference With IOL-based monovision, which has demonstrated the ability to correct presbyopia effectively, one eye is corrected for distance and the other for near. Based on the defocus test we perform in the office, 2 I have found that most patients are unable to tolerate a difference this large.
Moreover, commonly used items, such as cell phones, tablets and laptops fall in the intermediate zone. Traditional monovision does not provide clear vision for this intermediate range. I perform the Defocus Test as follows: Determine the dominant eye Place the distance prescription in the phoropter.
Occlude the nondominant eye near eye Add Stop adding minus diopters when sustained blur is reported. Note the interocular difference usually at least 1 D. Open both eyes with this new starting point and alternately or simultaneously add Note this greater difference of usually 2D or greater.
The test results lie between these two endpoints, generally between 1D and 1. For mini-monovision, I aim for the IOL power difference between the eyes to be no more than 0. I target the dominant eye for emmetropia and the nondominant eye between To date, we've had little trouble with patient adaptation due likely to the small interocular diopteric difference.
A greater difference between the eyes may lead to contrast sensitivity, stereopsis and binocular visual acuity issues. Minding the aberrations A key factor to take into consideration is the aberration profile of the IOL selected for monovision. In the past, spherical IOLs were used. Now, aspheric IOLs are available ranging from 0 to The negative asphericity of the implant is used to replicate the youthful lens, which neutralizes the positive SA of the cornea.
Studies have demonstrated that a small amount of positive SA may aid with an increased depth of focus, 3,4 allowing a greater range of overall vision. This allows for more precise IOL power titration. These two factors may allow for more predictable refractive outcomes.
Achieving predictable outcomes Similar to multifocal IOL patient selection, equal attention is required for the proper selection of traditional monovision candidates.Used Apple MacBook Pro for sale in Littleton - Apple MacBook Pro posted by Dominic Martinez in Littleton.
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Cynthia Matossian is an ophthalmologist in Pennington, New Jersey and is affiliated with Wills Eye Hospital. A Tale of Two Cases Matossian, C.
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|Wilson Graffiti Volleyball||IOL Alternatives to Multifocality Avoiding glare and halo while expanding focal depth is the primary goal of these implants. For many cataract patients, multifocal intraocular lenses have worked well and have afforded them a broader range of vision postoperatively.|
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