Monovision ideal for most presbyopes

Surgical monovision is an attractive option for presbyopes seeking refractive surgery and wanting freedom from glasses and contact lenses, according to Mark Mannis, MD, University of California, USA.

Dr Mannis presented results of a study that enrolled 87 subjects, aged 40 years of age or older, undergoing LASIK monovision. Preoperative refractive errors included spherical myopia, myopia with astigmatism, hyperopia, hyperopia with astigmatism and mixed astigmatism. Thirty-five patients had a contact lens trial preoperatively.

Postoperative mean spherical equivalent (SE) was 0.02 D in the distance eye and -1.27 D in the near eye. Overall, 98% of patients were satisfied with the procedure. Two patients underwent monovision reversal; neither had a preoperative contact lens trial. However, 31 eyes underwent LASIK enhancement, which most often was performed for the distance eye.

Dr Mannis commented, "practitioners should expect long chair times preoperatively and a relatively high enhancement rate postoperatively because even small amounts of astigmatism may require correction. In addition to careful screening and counselling, we also recommend a presurgical contact lens trial for all patients, suggest a minimum three-week acclimatization period after surgery, and use of 'glove box' glasses for scoptic conditions. In addition, this method is not recommended for certain patients, including pilots or professional drivers."