Lisa Feulner, MD, PhD, is a board-certified ophthalmologist in Maryland with over 20 years of experience performing cataract surgeries. She is recognized for her expertise as a comprehensive ophthalmologist and cataract/refractive surgeon. She is involved in clinical research and is a medical monitor for various clinical trials.
Benefits of the mini-monovision technique
Mini-monovision, also known as modified monovision, is a technique in which the dominant eye is treated with an IOL to enable clear distance vision while undercorrecting the nondominant eye. Mini-monovision utilizes a smaller interocular dioptric power difference between the two eyes compared to traditional monovision.1
For patients with significant astigmatism, mini-monovision can be achieved by using toric intraocular lens (IOL) implants (such as enVista toric) or limbal relaxing incisions (LRIs).1
Dr. Feulner noted that not every patient is a great candidate for a a presbyopic-correcting IOL (PC-IOL). However, most people prefer to be as spectacle independent as possible. For patients that are not good candidates for a PC-IOL, “The enVista monofocal lens provides a good compromise between vision quality and dept of focus which make it a especially good candidate for mini-monovision. Uniformly, my patients are VERY happy with their distance and near vision sight when I use the mini-monovision correction technique,” according to Dr. Feulner.
“The mini-monovision technique allows me to deliver great outcomes with the enVista IOL platform. This is an optimal balance between depth of field and quality of vision.”- Dr. Lisa Feulner
Oftentimes, the mini-monovision technique provides the patient with a better depth of field than correcting both eyes to the same degree.1 Interestingly, in Dr. Feulner’s experience, the brain is easily able to adapt using mini-monovision. Additionally, patients can realize cost savings over the use of multifocal IOLs and have reduced spectacle dependence.1
enVista IOLs have a multitude of benefits
A key benefit of enVista lenses is that they are glistening-free. Glistening is an issue that may impact patients’ vision and can occur early after cataract surgery, within months, or can develop years later.2 With the enVista platform of glistening-free IOLs, patients maintain visual clarity over time.2 Dr. Feulner appreciates the glistening-free quality of enVista, “There is nothing more frustrating than doing a fantastic surgery, and then years later, you see the patient and the lens is full of glistening.”
“I used to use other lenses. Once I experienced the enVista platform, I never went back.”- Dr. Lisa Feulner
Another benefit of The enVista IOL is how easy it is to place. enVista is available as a preload or for manual insertion. Dr. Feulner finds the lens very easy to maneuver and rotate inside the eye. She is also able to manipulate the lens easily to remove viscoelastic. She also observed that once the lens is placed, it is stable.
Additionally, enVista IOLs have an aspheric design with uniform power edge-to-edge. Thus, refractive ability is not altered significantly by tilt or decentration. If an event causing decentration occurs, as long as the pupil is aligned over a part of the lens, the patient will be able to see well.
The SimplifEYE injector makes it very easy to insert an enVista lens.
enVista toric IOLs are aberration-free
The aberration-free design of enVista gives a balance of vision quality and depth of focus in the right patients with the right corneas. In patients with aberrated corneas, such as post-refractive patients, this feature is an asset because you aren’t adding aberration to an already aberrated cornea.
Dr. Feulner noted, “I can feel assured that I am putting in an aberration-free IOL that won’t add to distortion through the cornea. That is such a plus to this lens. For an aberrated cornea, enVista is my go-to lens!”
Lisa K. Feulner, MD, PhD, received her degrees from the University of Rochester School of Medicine and Dentistry, where she attended as part of the prestigious Medical Scientist Training Program. Her graduate school research focused on molecular neuroscience at the Gerontology Research Center, National Institute on Aging, National Institutes of Health and at Johns Hopkins University. She founded Advanced Eye Care & Aesthetics in Bel Air, Maryland in 2003.
Financial Disclosure: Consultant to Bausch & Lomb