Multifocal Intraocular Lens x Monovision x Hybrid Monovision After Bilateral Cataract Surgery

The purpose of this study is to evaluate the results in randomized patients that receive bilateral multifocal IOLs, monofocal IOLs with monovision with emmetropia in one eye and 1.50 D of myopia in the other eye, or monofocal IOL in the dominant eye and multifocal IOL in the non-dominant eye, then evaluate visual and refractive outcomes, as well as independence for glasses after bilateral surgery with 1 year of follow up.

Inclusion criteria

• Bilateral senile cataracts.
• Implantation of IOL in the capsular bag;
• Implants from 10-30 diopter;
• Potential Visual Acuity in ≥ 0.2 logMAR (20/32, metric scale) after surgery;

Exclusion criteria

• Amblyopia;
• Single Eye;
• History of intraocular surgery in the previous year;
• Sequel to prior ocular trauma;
• Important Microphthalmia or aniridia;
• History of damage to the corneal endothelium (chemical burns, herpetic keratitis, corneal guttata);
• Corneal astigmatism > 1.0 D;
• IOP ≥ 21 mmHg in standard caliper;
• Ocular pathology that affects visual function (uveitis, diabetic retinopathy, age-related macular degeneration, macular dystrophy, retinal detachment, glaucoma, optic neuropathy);
• Pupil > 5 mm or < 2 mm under photopic conditions;
• Asymmetrical pupils in the eye or between the eyes;
• Binocular vision absence;
• Any situation that endangers the implant position in the capsular bag (post-traumatic zonular weakness, pseudoexfoliation, for example);
• Patient probably need to laser treatment of the retina;
• Patients whose expectations are unrealistic;
• Patients whose lifestyle involves high expectations of visual acuity (writer, driver, for example);
• Patients at risk of not meeting the clinical follow-up requirements (distance of travel difficulties, for example);