Monovision outcomes in presbyopic individuals after refractive surgery.
OBJECTIVE
To characterize monovision outcomes and patient satisfaction with conventional monovision (dominant eye corrected for distance) and crossed monovision (dominant eye corrected for near) in presbyopic individuals after excimer laser photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK).


METHODS
Retrospective observational case series.


METHODS
One hundred forty-four consecutive patients, 45 years or older, who were treated with excimer laser refractive surgery between December 1995 and June 1998.


METHODS
Patients in whom the surgical outcome was monovision (MV) (distance vision spherical equivalent [SE] -0.50 to +0.50 diopter (D), near vision SE -3.75 to -1.00 D and anisometropia 1.00 D or greater), crossed MV (dominant eye corrected for near vision and the nondominant eye for distance vision) and full correction (bilateral SE -0.50 to +0.50) were identified. Data were abstracted and analyzed statistically.


METHODS
Preoperative and postoperative visual acuity and refraction. Patient satisfaction with monovision


RESULTS
Forty-two patients had surgical outcome of MV. In MV patients, the average distance vision SE, near vision SE, and anisometropia were -0.04 +/- 0.27 D, -1.95 +/- 0.70 D, and 1.92 +/- 0.74 D, respectively. Patient satisfaction was 88% with MV. Twelve patients attained crossed MV. All patients with crossed MV were satisfied with their vision. Patient satisfaction with MV showed no relationship to gender, age at initial surgery, preoperative trial of monovision, laterality of treatment, type of monovision, or predictability of outcomes.


CONCLUSIONS
Monovision may be a valuable option for presbyopic individuals considering refractive surgery. Crossed monovision can result in satisfactory visual outcomes.
Jain
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Corneal and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, the Schepens Eye Research Institute, and Harvard Medical School, Boston, Massachusetts 02114, USA.
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Azar
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D003315:Cornea / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018903:Photorefractive Keratectomy; D011305:Presbyopia / Q000503:physiopathology* / Q000601:surgery; D012029:Refraction, Ocular; D012189:Retrospective Studies; D016896:Treatment Outcome; D015349:Vision, Monocular / Q000502:physiology*; D014792:Visual Acuity