Visual Outcomes of an Enhanced Monofocal Intraocular Lens Targeted for Monovision in Highly Myopic Eyes: a Randomized Controlled Trial

N/ANot Yet RecruitingNCT07168109

Zhongshan Ophthalmic Center, Sun Yat-sen University66 enrolled

Overview

The goal of this clinical trial is to evaluate whether an enhanced monofocal intraocular lens targeted for monovision can improve visual outcomes in patients with cataract and high myopia (axial length ≥ 26 mm). The main questions it aims to answer are: For people with cataract and high myopia, does an enhanced monofocal intraocular lens targeted for monovision provide greater binocular uncorrected distance visual acuity compared with targeting myopia in both eyes? Does an enhanced monofocal intraocular lens targeted for monovision provide comparable binocular uncorrected intermediate and near visual acuity, contrast sensitivity, reading ability, spectacle independence, stereopsis, and photic phenomena compared with targeting myopia in both eyes? Researchers will compare an enhanced monofocal intraocular lens targeted for monovision with one targeted for myopia in both eyes to determine whether the monovision strategy is more effective. Participants will: Undergo phacoemulsification with enhanced monofocal intraocular lens implantation. Attend follow-up visits at 1, 3, 6, and 12 months after cataract surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Cataract High Myopia

Enhanced monofocal intraocular lens implantation (monovision strategy)PROCEDURE

Participants will undergo phacoemulsification with the implantation of an enhanced monofocal intraocular lens, targeting -0.5 D in the dominant eye and -2.0 D in the non-dominant eye. The first operated eye will be selected based on the worse corrected distance visual acuity; if both eyes are similar, the eye subjectively perceived by the patient as having worse vision will be chosen. The second eye surgery will be performed within 2 weeks after the first eye surgery. Ocular dominance will be determined preoperatively using the "finger method" . Intraocular lens power will be calculated using multiple formulas \[Emmetropia Verifying Optical (EVO) version 2.0, Kane, LISA\].

Enhanced monofocal intraocular lens implantation (bilateral myopia strategy)PROCEDURE

Participants will undergo phacoemulsification with the implantation of an enhanced monofocal intraocular lens, targeting -2.0 D in both eyes. The first operated eye will be selected based on the worse corrected distance visual acuity; if both eyes are similar, the eye subjectively perceived by the patient as having worse vision will be chosen. The second eye surgery will be performed within 2 weeks after the first eye surgery. Ocular dominance will be determined preoperatively using the "finger method". Intraocular lens power will be calculated using multiple formulas \[Emmetropia Verifying Optical (EVO) version 2.0, Kane, LISA\].

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age between 18 and 85 years (inclusive), no gender restrictions; 2. Scheduled to undergo bilateral phacoemulsification with intraocular lens implantation; 3. Axial length ≥ 26.0 mm in both eyes; 4. Desire for postoperative spectacle independence; 5. Able to understand and cooperate with the trial procedures, voluntarily participate in this clinical trial, and sign an informed consent form. Exclusion Criteria: 1. Poor-quality preoperative ocular biometry (Axial length, keratometry, anterior chamber depth); 2. Preoperative corneal astigmatism ≥ 1.5 diopters (D); 3. Patients with intraoperative or postoperative complications (ie, intraoperative posterior capsular rupture, zonular dehiscence, secondary glaucoma, etc.); 4. The presence of other ocular diseases (ie, strabismus, severe retinal pathology, uveitis, other relevant ophthalmic diseases that might affect outcomes or trauma, etc.); 5. A history of intraocular surgery; 6. Severe chronic systemic diseases, psychiatric disorders, dementia, hearing impairments, or mobility limitations that would interfere with understanding of the monovision design, attendance at follow-up visits, or completion of questionnaires.

Outcomes

Primary Outcomes

Binocular uncorrected distance visual acuity at 4 m

measured by the ETDRS chart

Time frame: 3 months (±2 weeks) following the second eye surgery

Secondary Outcomes

Monocular and binocular uncorrected distance visual acuity at 4 m

measured by the ETDRS chart

Time frame: 1, 6, 12 months following the second eye surgery

Monocular and binocular uncorrected intermediate visual acuity at 80cm and 60cm

measured by the EDTRS chart

Time frame: 1, 3, 6, 12 months following the second eye surgery

Monocular and binocular uncorrected near visual acuity at 40cm

measured by the EDTRS chart

Time frame: 1, 3, 6, 12 months following the second eye surgery

Monocular and binocular defocus curves

measured by the binoptometer 4P