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Monovision Surgery in Myopic Presbyopes: Visual Function and Satisfaction

Levinger, Eliya*; Trivizki, Omer*; Pokroy, Russell*; Levartovsky, Shmuel*; Sholohov, Galina*; Levinger, Samuel*

doi: 10.1097/OPX.0000000000000002
Original Articles

Purpose 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.

Omer Trivizki, MD, Department of Ophthalmology, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel e-mail: omertr@gmail.com

© 2013 American Academy of Optometry