SUCCESS OF MONOVISION IN PRESBYOPES - REVIEW OF THE LITERATURE AND POTENTIAL APPLICATIONS TO REFRACTIVE SURGERY

The monovision concept of correcting one eye for distance and the othe r for near may be utilized in presbyopes undergoing refractive surgery . We have performed a systematic review of published literature to eva luate the factors influencing monovision success, and to determine the visual outcome in patients with monovision. Articles in MEDLINE and p ublished bibliographies reporting mono-vision prescription for correct ion of presbyopia were systematically identified and reviewed. Pertine nt data were abstracted and, when feasible, statistically analyzed. Th e mean success rate was 73%. The success in monovision correlated with distance correction on dominant eye, alternating dominance, less than 50 seconds of are stereoacuity reduction, and less than 0.6 prism dio pter of distance esophoric shifts. Monovision resulted in significant reduction of binocular contrast sensitivity function at spatial freque ncies higher than 4 cycles per degree, and 2-6% reduction in task perf ormance, but resulted in minimal reduction of binocular visual acuity, peripheral vision, visual field width and binocular depth of focus. T he published literature indicates that monovision is an effective and reasonable therapeutic modality for correcting presbyopia. Proper pati ent selection and clinical screening are essential for monovision succ ess.