Long-term observation of monovision surgery using femtosecond laser- assisted laser in situ keratomileusis for myopia correction in early presbyopia

Abstract

Abstract Purpose: This study aimed to investigate the long-term safety and efficacy of femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in patients with myopia with presbyopia. Methods: This case series study included 30 eyes of 15 patients who underwent monovision designed FS-AISK for myopia correction with presbyopia (male/female, 8/7; age, 49.20±7.05 years; spherical equivalent [SE], –6.97±1.82 D). Parameters including SE; uncorrected distal visual acuity (VA); corrected distal VA; intraocular pressure; presbyopic add power; VA of dominant eyes (D-eye), non-dominant (nD-eye) eyes, and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m; wavefront aberration; and contrast sensitivity (CS) were recorded. Follow-up was performed for 2.5 years. Differences were considered statistically significant at p<0.05. Results: The safety indicesand efficacy indices were 1.08±0.19 and 0.77±0.29 at 2.5 years postoperatively. The VAs (logMAR) of D-eyes, nD-eyes, and Bi at 5.0 m, 0.8 m, and 0.4 m were –0.02±0.08, 0.26±0.19 (D-eyes vs. nD-eyes, p<0.01), and –0.29±0.06; 0.05±0.14, 0.02±0.11 (D-eyes vs. nD-eyes, p>0.05), and –0.03±0.07; and 0.21±0.17, 0.01±0.07 (D-eyes vs. nD-eyes, p<0.001), and –0.02±0.07, respectively. The binocular VA was >20/25 (Snellen lines) at three distances in 100% of the subjects. Between the D-eyes and nD-eyes in CS, a minor but significant difference was observed at 1.5–12.0 cpd. Conclusions: FS-LASIK is safe and practical for the correction of myopes with presbyopia, with long-term efficacy at near and far distances. Compared with D-eyes, the CS in nD-eyes may be impaired at low and moderate spatial frequencies.