Objectives: The study aimed to compare stereopsis, aniseikonia, and associated symptoms in bilateral pseudophakia with and without anisometropia. Methods: Patients with senile cataracts, previously scheduled for phacoemulsification with an IOL implant in both eyes were included in this cross-sectional study. Patients were divided into two groups: control group (n = 69) with an interocular post-surgical refraction difference in Spherical Equivalent (SE) < 1.0 D and anisometropia group (n = 42) with an interocular post-surgical difference in SE ≥ 1.00 D. Aniseikonia was evaluated by Aniseikonia InspectorTM 3 and stereopsis by Randot?; Stereotest. Ten symptoms related to aniseikonia were evaluated with a questionnaire. Statistical evaluation of data included models of univariate, multivariate, and regression analyses. Results: Cataract surgery-induced aniseikonia was 0.64% ± 1.41% in control group and 0.62% ± 1.76% in anisometropia group with an insignificant difference (p = 0.766). Measured stereoacuity was 1.95 ± 0.17 log10 seconds of arc in the control group and 2.12 ± 0.22 log10 seconds of arc in the anisometropia group with a significant difference (p < 0.0001). The mean score of symptoms associated with aniseikonia was 1.41 ± 0.46 in the control group and 1.47 ± 0.45 in the aniso- metropia group, with an insignificant difference (p = 0.387). The contribution of independent variables in predicting stereopsis in the anisometropia group was the following: axial length difference (18.06%); refractive error difference (SE) (44.53%), aniseikonia (25.71%), and IOL power difference (11.71%). Conclusions: The study showed that stereopsis, aniseikonia, and associated symptoms did not stand for a substantial problem for visual comfort of bilateral pseu- dophakia with anisometropia less than 3D.
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