Purpose: Induced myopic astigmatism improves the monocular near logMAR (logarithm of the minimal angle of resolution) acuity of pseudophakes with monofocal intraocular lens implants but with a small loss in distance acuity. The impact of induced astigmatism on binocular vision of pseudophakes remains unknown. This study determined the impact of bilaterally induced astigmatism on binocular distance and near logMAR and stereoacuity of bilateral pseudophakes with monofocal intraocular lens implants.
Methods: Distance (3 m) and near (40 cm) logMAR acuity and near (40 cm) stereoacuity were measured in 15 bilateral pseudophakes with 10 different combinations of induced astigmatism. Combinations were chosen such that one eye had no astigmatism or 1 diopter (D) myopic astigmatism at 90 degrees axis or 1 D hyperopic astigmatism at 90 degrees axis. The fellow eye had the same error or that with orthogonal axis (180 degrees) or different magnitude (2.5 D) or opposite polarity.
Results: Distance logMAR acuity deteriorated by up to 0.2 logMAR units from median best-corrected values (-0.06 logMAR) only for bilaterally induced (p < 0.01) but not for unilaterally induced (p > 0.9) astigmatism. Near logMAR acuity and stereoacuity improved by up to 0.25 logMAR units and 130 arc sec from their respective median uncorrected values (0.65 logMAR and 225.8 arc sec) for induced myopic astigmatism (p < 0.001). Near acuity was similar or worse than uncorrected values for induced hyperopic astigmatism (p ≥ 0.003). Stereoacuity was better with parallel than with orthogonal axes of induced myopic astigmatism in the two eyes (p = 0.001). LogMAR acuity did not change with axis of astigmatism in the two eyes (p > 0.6).
Conclusions: Distance and near logMAR acuity and stereoacuity of bilateral pseudophakes vary with the combination of astigmatism induced before two eyes. Combinations with myopic astigmatism partly benefit binocular near vision, albeit with a loss of distance vision. Near stereoacuity is better with parallel than with orthogonal axes of myopic astigmatism in the two eyes. Visual performance is equal to or worse than uncorrected condition for hyperopic astigmatism.
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