Monovision is a method of correcting presbyopia where one eye is focused for far and the other for near vision. It is a simple, cost effective approach to overcome the loss of accommodation with age and to become spectacles independent.
50 patients where bilateral cataract extraction was indicated were included in this study performed at the St. Joseph’s Eye Hospital in Kinshasa (DR Congo). Small incision cataract surgery technique (SICS) was applied with the implantation of 6 mm PMMA lenses in the capsular bag. IOL refractive power choice was made to achieve a postoperative refraction of -0.5 dpt for the eye selected for far vision. The second eye received an implant heading for a postoperative myopia of -1.5 dpt suitable for intermediated and near vision. According to the literature, monovision criteria have been regarded as fulfilled when (1) far vision was 0.5 (logMAR) or better and (2) near vision was P3 (0.40, Decimal 32 cm) or better. Spectacle dependence after bilateral cataract surgery heading for monovision was analyzed using a dedicated questionnaire.
Out of all 50 patients 22 (44%) fulfilled the above defined criteria of monovision in terms of postoperative refraction and visual acuity. 19 out of these 22 (86.3%) patients where happy without glasses. Two of them used bifocal spectacles whereas the remaining patient refused spectacles. 28 patients did not fulfill monovision criteria. Out of these 28 patients however 9 (32.1%) of them are happy without glasses.
In view of the described local circumstances aiming for monovision after bilateral cataract surgery is a suitable approach to optimize cataract surgical outcomes with no extra costs for surgery but considerable improvement of patient’s visual performance in daily life.

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