Visual Outcomes of LASIK-Induced Monovision in Myopic Patients With Presbyopia

PURPOSE: To evaluate binocular visual acuity (VA), contrast sensitivity, and stereopsis in myopic patients after laser in situ keratomileusis (LASIK)-induced monovision. DESIGN: Prospective, observational study. METHODS: We performed a prospective study of 37 consecutive patients older than 45 years who underwent bilateral myopic LASIK with planned monovision. At the 6-month postoperative visit, we evaluated distance and near binocular visual acuity, contrast sensitivity, and stereopsis. Binocular tests were done without spectacles (in monovision condition) and compared with the results obtained by repeating the same binocular tests with the same patients (serving as a control group) after spectacle correction of the residual myopic defect in the nondominant eye for distance tests (reverting monovision) and after spectacle correction of the presbyopia bilaterally for near tests (near best spectacle-corrected VA). RESULTS: By inducing a mean residual spherical equivalent defect of -0.97 diopter in the nondominant eye, the patients achieved a mean near binocular uncorrected visual acuity (UCVA) of 0.74, a mean reading test binocular UCVA of 0.88 using an acceptable spontaneous reading distance (48 cm), and a mean distance binocular UCVA of 1.08. A slight decrease in contrast sensitivity and stereopsis was observed in monovision compared to full distance correction. CONCLUSIONS: Monovision is a valid option for myopic patients with presbyopia who are considering LASIK. Good distance and near UCVAs can be obtained with this procedure. (Am J Ophthalmol 2010; 150:381-386. (C) 2010 by Elsevier Inc. All rights reserved.)