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Journal List > J Korean Ophthalmol Soc > v.53(1) > 1009133

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

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.

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jkos-53-11f1.tif
Figure 1.
Histogram showing the accuracy to the intended spherical equivalent refraction 3 months after treatment.
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jkos-53-11f2.tif
Figure 2.
Cumulative histogram for the distribution of the de-focus equivalent 3 months after treatment.
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jkos-53-11f3.tif
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.
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jkos-53-11f4.tif
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.
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jkos-53-11f5.tif
Figure 5.
Comparison of postoperative depth of focus (A) and spherical aberration (B).
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jkos-53-11f6.tif
Figure 6.
Survey for quality of vision and satisfaction in patients after the treatment.
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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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