Early Outcomes of Two Treatment Modes of PresbyLASIK: Monocular vs. Micro-Monovision

Abstract

Purpose To report the visual, refractive and subjective outcomes of presbyLASIK for the correction of presbyopia. Methods Monocular (20 eyes) or micro-monovision (12 eyes) presbyLASIK was performed on a total of 32 eyes in 16 patients (50% female, average age 55±4.6 years) using the Zeiss VisuMax 400Hz femtosecond and Schwind Amaris 1050RS excimer laser platform. Predictability, safety and efficacy were assessed and compared at 4–6 weeks, 3 months and 6 months. Results were considered significant if P < 0.05. Results For monocular treatments, average postoperative spherical equivalent (SE) was 0.1±0.1 D and −0.86±0.5 D at 4–6 weeks postoperatively for distance and near eyes respectively; 90% eyes achieved SE ±1.0 D of the target. Postoperative binocular uncorrected distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA) were −0.03±0.1 LogMAR (20/20), 0.09±0.26 LogMAR (N4) and 0.29±0.11 LogMAR (N6) respectively with 90% patients achieving binocular UDVA of 20/20 or better. For micro-monovision treatments, average postoperative SE was −0.33±0.51 D and −1.60±0.78 D at 4–6 weeks postoperatively for distance and near eyes respectively; 100% eyes achieved SE ±1.0 D of the target. Postoperative binocular UDVA, UIVA and UNVA were 0.05±0.16 LogMAR (20/20), −0.02±0.10 LogMAR (N3) and 0.23±0.08 LogMAR (N5) respectively with 67% patients achieving binocular UDVA of 20/20 or better. Conclusion Monocular and micro-monovision presbyLASIK are both effective options for the treatment of presbyopia. Monocular treatments are more likely to be well tolerated by patients who prefer to preserve exceptional distance vision, while micro-monovision treatments may be better suited to patients who can tolerate compromises in distance vision in order to attain greater intermediate vision function.

Exploring the Effect of Preoperative Stereopsis on Visual Outcomes in Hyperopic Presbyopes Treated with PresbyOND® Laser Blended Vision Micro-Monovision

“…However, one conspicuous gap in current knowledge is the influence of preoperative visual conditions-most prominently, stereopsis-on the outcomes after surgical intervention [7]. It is important to note that hyperopic presbyopes constitute a significant segment of the population grappling with presbyopia, yet the existing literature seldom pays focused attention to them [8].…”