LASIK for presbyopia correction in emmetropic patients using aspheric ablation profiles and a micro-monovision protocol with the Carl Zeiss Meditec MEL 80 and VisuMax.

PURPOSE: To evaluate the monocular and binocular visual outcomes of LASIK with an aspheric micro-mono-vision protocol in emmetropic patients with presbyopia.

METHODS: A retrospective, noncomparative case series included 296 eyes from 148 consecutive emmetropic patients with presbyopia who were treated with LASIK-induced micro-monovision. The CRS-Master software was used to generate ablation profiles for the MEL 80 excimer laser (Carl Zeiss Meditec) and flaps were created using the VisuMax femtosecond laser (Carl Zeiss Meditec). The target refraction was plano for distance eyes (dominant eye) and between -1.00 and -1.88 diopters (D) for near eyes. Patients were followed for 1 year. Emmetropia was defined for inclusion as spherical equivalent refraction ⩾- 0.88 D, sphere ⩽+1.00 D, and cylinder ⩽1.25 D. Median patient age was 55 years (range: 44 to 65 years). Median follow-up was 12.9 months.

RESULTS: Mean deviation from intended correction was +0.02±0.35 D, with 91% within ±0.50 D and 100% within ±1.00 D. Of distance eyes, 95% achieved uncorrected distance visual acuity (UDVA) of 20/20 or better and 100% achieved 20/32 or better. Binocularly, 98% of patients achieved UDVA of 20/20 or better and 100% achieved 20/32 or better; 96% achieved uncorrected near visual acuity of J2 and 99% could read J3 or better. No eyes lost 2 or more lines of corrected distance visual acuity. An average increase of 0.05 logMAR was noted in distance-corrected near visual acuity. A small increase occurred in mesopic contrast sensitivity (CSV-1000, VectorVision Inc) at 3 cycles per degree (cpd) (P=.016) and no change at 6, 12, or 18 cpd.

CONCLUSIONS: This aspheric micro-monovision protocol was a well-tolerated and effective procedure for treating emmetropic patients with presbyopia.