LASIK for Myopia with Presbyopia Using the Aspheric Micro-Monovision Technique

Kunho Bae; Ji Eun Keum; Tae-Young Chung; Eui-Sang Chung

doi:10.3341/jkos.2012.53.1.11

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Bae, Keum, Chung, and Chung: LASIK for Myopia with Presbyopia Using the Aspheric Micro-Monovision Technique

Original Article

J Korean Ophthalmol Soc 2012;53(1):11-19.

Published online: 7 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.1.11

LASIK for Myopia with Presbyopia Using the Aspheric Micro-Monovision Technique

Kunho Bae, MD¹, Ji Eun Keum, MD², Tae-Young Chung, MD, PhD¹, Eui-Sang Chung, MD, PhD¹

¹Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

²Nune Eye Hospital, Seoul, Korea

Address reprint requests to Eui-Sang Chung, MD, PhD Department of Ophthalmology, Samsung Medical Center #50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea Tel: 82-2-3410-6776, Fax: 82-2-3410-0027, E-mail: eschung@skku.edu

Received 8 June 20115 October 2011 Accepted 8 December 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the efficacy, safety, and satisfaction of patients who underwent the aspheric micro-monovision protocol for the correction of myopia with presbyopia.

Methods

A retrospective, noncomparative study included 40 eyes of 20 consecutive patients with myopia and presbyopia who were treated with LASIK-induced micro-monovision. Monocular and binocular visual outcomes of uncorrected and best-corrected distance, intermediate, and near visual acuity were measured. Depth of focus, spherical aberration, stereopsis and satisfaction were evaluated before surgery and 3 months after surgery.

Results

Mean patient age was 48.7 years. Monocular uncorrected distance visual acuity was 0.8 in 94% of dominant eyes, and monocular uncorrected near visual acuity was J3 in 94% in non-dominant eyes. Binocular uncorrected near visual acuity was J2 in 94% and J5 in 100% of dominant and non-dominant patient eyes, respectively. Binocular uncorrected distance visual acuity was 1.0 in 100% of patients, and binocular uncorrected near visual acuity was J2 in 94% of patients. Our results showed a significant improvement in depth of focus and a positive shift in spherical aberration in dominant eyes; however, there were no significant changes in the non-dominant eyes. There was no change in stereopsis or contrast sensitivity at any of the tested spatial frequencies. Satisfactory scores were achieved in all eyes.

Conclusions

The aspheric myopic micro-monovision protocol was well-tolerated, stable, and effective for treating patients with presbyopia in myopic astigmatism.

Keywords: Depth of focus, LASIK, Monovision, Myopia, Presbyopia

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Figure 1.

Histogram showing the accuracy to the intended spherical equivalent refraction 3 months after treatment.

Figure 2.

Cumulative histogram for the distribution of the de-focus equivalent 3 months after treatment.

Figure 3.

Changes of binocular and monocular uncorrected distant visual acuity 3 months after treatment. (A) Uncorrected distant visual acuity, (B) Uncorrected near visual acuity, (C) Uncorrected intermediate visual acuity. D = dominant eye; ND = non-dominant eye; B = binocular.

Figure 4.

Combined distance and near binocular uncorrected distance visual acuity 3 months after treatments. Near vision is displayed on the x axis, distance vision is displayed on the y axis, and the percentage of patients with each combination of distance and near vision is plotted.

Figure 5.

Comparison of postoperative depth of focus (A) and spherical aberration (B).

Figure 6.

Survey for quality of vision and satisfaction in patients after the treatment.

Table 1.

Mean apherical equivalent refraction of distance and near eyes before and after the treatment

Mean spherical equivalent refraction (D)
Eye	Preoperative	Intended after treatment	Attempted	Postoperative 3 mon
D	-3.09 ± 1.76	-0.01 ± 0.03	-3.11 ± 1.92	0.03 ± 0.15
	(−0.30 to −7.25)	(0.00 to −0.13)	(−0.30 to −7.25)	(0.25 to −0.38)
ND	-3.11 ± 1.74	-1.39 ± 0.20	-1.55 ± 1.84	-1.34 ± 0.28
	(−0.50 to −7.50)	(−0.75 to −1.50)	(+1.00 to −6.05)	(−0.63 to −1.88)

Values are mean ± SD.

D = dominant eye; ND = non-dominant eye.

Table 2.

Comparison of postoperative binocular and monocular uncorrected near visual acuity

	Postoperative (%)
Binocular UNVA worse than near eye monocular UNVA	0.0
Binocular UNVA the same as near eye monocular UNVA	75.0
Binocular UNVA 1 line better than near eye monocular UNVA	25.0
Binocular UNVA 2 lines better than near eye monocular UNVA	0.0

UNVA = uncorrected near visual acuity.

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