Binocular function and patient satisfaction after monovision induced by myopic photorefractive keratectomy

Purpose: To measure binocular function and patient satisfaction with monovi sion induced by photorefractive keratectomy (PRK) in myopic presbyopic pati ents. Setting: Refractive Department, Cleveland Clinic, Cleveland, Ohio, USA. Methods: This study comprised 21 myopic presbyopic patients with monovision induced by PRK. Sixteen emmetropic patients who had PRK served as a contro l group. Monovision was induced by undercorrecting the nondominant eye by 1 .25 diopters for near vision and correcting the dominant eye with emmetropi a for distance vision. Monocular and binocular uncorrected Snellen visual a cuities at 20 feet and 13 inches, manifest refraction, ocular dominance, st ereopsis at 20 feet and 13 inches, monocular and binocular contrast sensiti vities, Worth-4-Dot test at 20 feet and 1/3 of a meter, and fusional conver gence amplitudes were examined in each patient. Results: In the monovision group at near and distance, 20 patients (95.3%) had binocular visual acuity of 20/25 or better. No patient in the monovisio n group used reading glasses postoperatively; 4 of 16 patients (25.0%) in t he control group used such glasses. Ali patients maintained binocular fusio n and stereo acuity ranging from 40 to 800 seconds of are. Mean patient sat isfaction was 86% (range 40% to 100%). In the control group. 12 patients (7 5.0%) had binocular distance visual acuity of 20/25 or better and 11 (68.8% ) had binocular near visual acuity of 20/125 or better. Conclusion: Monovision PRK patients had better near vision than control PRK patients, with minimal compromise in stereo acuity and overall high patien t Satisfaction.