Monovision outcomes in presbyopic individuals after refractive surgery

Purpose: To characterize monovision outcomes and patient satisfaction with conventional monovision (dominant eye corrected for distance) and crossed m onovision (dominant eye corrected for near) in presbyopic individuals after excimer laser photorefractive keratectomy (PRK) and laser in situ keratomi leusis (LASIK). Design: Retrospective observational case series. Participants. One hundred forty-four consecutive patients, 45 years or olde r, who were treated with excimer laser refractive surgery between December 1995 and June 1998. Methods: Patients in whom the surgical outcome was monovision (MV) (distanc e vision spherical equivalent [SE] -0.50 to +0.50 diopter (D), near vision SE -3.75 to -1.00 D and anisometropia 1.00 D or greater), crossed MV (domin ant eye corrected for near vision and the nondominant eye for distance visi on) and full correction (bilateral SE -0.50 to +0.50) were identified. Data were abstracted and analyzed statistically. Main Outcome Measures: Preoperative and postoperative visual acuity and ref raction. Patient satisfaction with monovision. Results. Forty-two patients had surgical outcome of MV. In MV patients, the average distance vision SE, near vision SE, and anisometropia were -0.04 /-0.27 D, -1.95 +/-0.70 D, and 1.92 +/- .74 D, respectively. Patient satisf action was 88% with MV. Twelve patients attained crossed MV. All patients w ith crossed MV were satisfied with their vision. Patient satisfaction with MV showed no relationship to gender, age at initial surgery, preoperative t rial of monovision, laterality of treatment, type of monovision, or predict ability of outcomes. Conclusions: Monovision may be a valuable option for presbyopic individuals considering refractive surgery. Crossed monovision can result in satisfact ory visual outcomes. Ophthalmology 2001;108:1430-1433 (C) 2001 by the Ameri can Academy of Ophthalmology.