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Abstract
Purpose
To compare the efficacy and safety of Laser Blended Vision (LBV) and monovision laser refractive surgery (monovision) for presbyopia correction in patients with myopia.
Methods
This retrospective comparative study included 42 eyes of 21 patients with LBV and 50 eyes of 25 patients with monovision. Monocular and binocular distance, intermediate and near visual acuity, and refractive changes were evaluated pre-operatively and 3 months after the surgery and compared. The patients in the LBV group underwent further evaluation of spherical aberration 3 months after the surgery and treatment satisfaction 3–6 months after the surgery.
Results
The mean age of the patients was 47.9 years in the LBV group and 41.7 years in the monovision group. Three months after surgery, the spherical equivalents were +0.11 ± 0.17 D in the dominant eye and −1.52 ± 0.36 D in the non-dominant eye in the LBV group. In contrast, the spherical equivalents were +0.23 ± 0.26 D in the dominant eye and −0.82 ± 0.28 D in the non-dominant eye in the monovision group. All patients achieved a binocular uncorrected distance visual acuity of 0.10 (log MAR) or better, and 86% of the LBV group and 100% of the monovision group achieved a binocular uncorrected intermediate visual acuity of better than 0.10. Moreover, 95% of the LBV group and 100% of the monovision group achieved a binocular uncorrected near visual acuity of better than 0.18. In the LBV group, mean spherical aberration increased after surgery than before, but it was not statistically significant. Complications such as corneal opacity that could decrease visual acuity were absent in both groups. Overall patient satisfaction after surgery was 80% in the LBV group.
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Figure 1.
Refractive change in laser blended vision (LBV) and monovision. Preoperation and 3 months after surgery. Pre-op = preoperation; Post-op = preoperation.
Figure 2.
Cumulative histogram of visual acuity after laser blended vision (LBV) and monovision. (A) Uncorrected distance visual acuity. (B) Uncorrected near visual acuity. (C) Uncorrected intermediate visual acuity.
Figure 3.
Comparison between laser blended vision (LBV) and monovision. (A) Binocular visual acuity. There was no statistically significant difference in distance, intermediate, and near visual acuity. (B) Dominant eye visual acuity. Monovision had better near visual acuity. (C) Non-dominant eye visual acuity. There was no statistically significant difference in distance, intermediate, and near visual acuity. UDVA = uncorrected distance visual acuity at 4 m; UIVA = uncorrected intermediate visual acuity at 80 cm; UNVA = uncorrected near visual acuity at 33–40 cm. * p-value was acquired from Mann-Whitney U-test.
Figure 4.
Corneal spherical aberration of laser blended vision. At 3 months postoperatively, spherical aberration increased in non dominant and dominant eye. Pre-op = preoperation; Post-op = postoperation. * p-value was acquired from Wilcoxon signed rank test.
Figure 5.
Safety: changes of postoperative best corrected distant visual acuity. There was no visual loss at 3 months postoperatively. LBV = laser blended vision.
Figure 6.
Overall satisfaction after Laser blended vision. Eighty percent of the patients were satisfied with the results of the operation.
Table 1.
Patients demographics
| Parameter |
Values |
p-value* | |
|---|---|---|---|
| Laser blended vision | Monovision | p-value | |
| Number (patients) | 21 | 25 | – |
| Age (years) | 47.90 ± 4.72 | 41.68 ± 1.93 | <0.001 |
| Male:Female | 6:15 | 4:21 | 0.343 |
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