Monovision surgery in myopic presbyopes: visual function and satisfaction.
OBJECTIVE
To describe our experience with monovision excimer laser correction in individuals with myopic presbyopia.


METHODS
This prospective interventional case series was conducted in a private refractive surgery center on 40 patients with presbyopia aged 40 years and older, who were treated with monovision refractive surgery between 2010 and 2011. The dominant eye was corrected for distance vision and the nondominant eye was corrected for near vision, with anisometropia of ≥1.00 diopters (D). All patients underwent comprehensive objective and subjective visual assessments, including a questionnaire that was filled out preoperatively and at 6 and 12 months postoperatively. The primary outcomes were preoperative and postoperative refraction, binocular visual acuity, stereopsis, contrast sensitivity, glare, and questionnaire results.


RESULTS
The 1-year follow-up was completed by 38 patients (95%). Preoperative and 1-year postoperative refraction of the distance eye spherical equivalent (SE), anisometropia SE, and uncorrected visual acuity were -4.05 ± 1.94 and -0.01 ± 0.22 D, 0.45 ± 0.50 and 1.73 ± 0.56 D, and 0.87 ± 0.2 and 0.09 ± 0.11 logMAR, respectively. Best-corrected visual acuity was unchanged. Both mean distance and near stereopsis decreased, from 52 to 142 seconds of arc and from 54 to 57 seconds of arc, respectively. Contrast sensitivity and glare decreased significantly. Patient satisfaction improved from 41.5 ± 30.4% to 85.2 ± 5.0% (range, 40 to 100%) at the 1-year follow-up.


CONCLUSIONS
Monovision excimer laser correction provides both effective and satisfactory results and should be considered as an option for individuals with myopic presbyopia suitable for, and interested in, refractive surgery.
*MD Enaim Refractive Surgery Center (EL, OT, SL), Jerusalem; Department of Ophthalmology (EL, OT), Sourasky Tel-Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University; Department of Ophthalmology (RP, GS), Hillel Yaffe Medical Center, Hadera; and Barzilai Medical Center (SL), Ashkelon, Israel.
Eliya
E
Levinger
Omer
O
Trivizki
Russell
R
Pokroy
Shmuel
S
Levartovsky
Galina
G
Sholohov
Samuel
S
Levinger
D000328:Adult; D000368:Aged; D015858:Anisometropia / Q000601:surgery; D015350:Contrast Sensitivity / Q000502:physiology; D003867:Depth Perception / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D010549:Personal Satisfaction; D011305:Presbyopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology*