ASCRS 2024: Binocularity and stereoacuity in modern monovision with a small-aperture IOL

William F. Wiley, MD, shares some key takeaways from his presentation on binocularity and aperture optics during ASCRS 2024 with Ophthalmology Times.

Video Transcript

Editor's note - This transcript has been edited for clarity.

William F. Wiley, MD: Hi, Dr. William Wiley here at ASCRS in Boston. I'm the medical director of Cleveland Eye Clinic, and here I'm giving a presentation on binocularity and aperture optics.

As we know, when looking at monovision, we treat a lot of patients with traditional monovision—one eye set for distance and one eye set for a little bit better up-close vision. Typically, to get a good near effect you might have to target -150 to get that monovision near effect. However, what we notice—yes, you do get near vision but you often lose stereoacuity when you target too near.

What we found, though, is with aperture optics, that aperture allows you to target less near, so you can target about -75 with an aperture optic. It's going to deliver the near vision, intermediate, and maintain some of the distance vision. So, you're going to have maintenance of distance vision, but picking up intermediate and near vision. And, also, you don't lose that stereoacuity effect like you see with traditional monovision.

So, with the aperture monovision, more or less, you're getting distance, intermediate, and near without sacrificing stereoacuity.