Satisfaction and success of modest monovision laser refractive surgery

Session Details

Session Title: Presbyopic Corrections

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 17:50

Venue: Boulevard F (Level 1)

First Author: : R.Schwartz ISRAEL

Co Author(s): :    E. Cohen   D. Varssano   A. Rosenblatt   G. Mintzer   T. Sela  

Abstract Details

Purpose:

To compare the success and satisfaction of refractive surgery in patients aimed for modest monovision with the same parameters in patients aimed for emmetropia.

Setting:

Patients treated with either Laser-Assisted in situ Keratomileusis (LASIK) or photorefractive keratectomy (PRK) in Care vision, Tel Aviv, Israel.

Methods:

Patients undergoing refractive surgery in the years 2007-2008 and aimed for modest monovision were contacted 6 years after the surgery and answered a phone questionnaire. Age matched patients undergoing consecutive surgery with the monovision group but aimed for emmetropia served as the control group and were also interviewed. Questions included general satisfaction; need for refractive correction while driving, while watching television, while using the computer and while reading; and side effects including halos and glare. Other parameters, including spherical equivalent (SE), uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were also evaluated preceding and following surgery.

Results:

Three hundred fifty seven eyes of 208 patients were included. Of those, 116 were interviewed. Control group included 63 patients . Patient age was 45.8±5.0 (mean±S.D.) . Study patients were 53.2% male, and 64.7% underwent LASIK . Pre-operative UCVA and BCVA were 1.35±0.49 and -0.02±0.08 LogMAR respectively in eyes aimed for near in the study group and 1.19±0.52 and -0.03±0.07 in eyes aimed for distance. In the control groupvalues were 1.31±0.61 and 0.01±0.06 respectively.Post-operative UCVA and BCVA were 0.37±0.29 and 0.0±0.07 respectively in eyes aimed for near in the study group, 0.01±0.20 and 0.0±0.09 in eyes aimed for distance, and 0.11±0.20 and 0.02±0.07 in controls. Study eyes aimed for near had pre and post operative mean SE of -4.84±2.14D and -0.85±0.72D respectively. Eyes aimed for distance had -3.67±2.28D and -0.13±0.66D respectively. Control pre and post operative SE were -2.98±3.13D and -0.05±0.70D respectively. General satisfaction was similar between groups. Need for glasses for driving (p=0.201), for watching television (p=0.204) or for using a computer (p=0.424) was similar. Study patients had less need for glasses for reading (P=0.015) ( 64.7% had no need for glasses Vs. 46.8% Controls (P=0.021). The rate of halos and glares was similar in both groups (p=0.189).

Conclusions:

As can be expected, monovision treatment decreases the need for refractive correction in daily activities such as using the computer and reading. Surprisingly, emmetropic correction may serve similar effects to monovision correction, including reading, in some patients, with almost 50% not needing correction for reading - possibly due to the young age of patients in this study, who may still have accommodative abilities. Unlike findings in similar studies, we did not find a difference in the rate of halos or glare between patients aimed for monovision and emmetropia.

Financial Interest:

NONE