Monovision and LASIK By Kristina Oneill on August 23, 2013



Monovision and LASIK


Monovision can be a very effective treatment for presbyopia, offering high rates of patient satisfaction.  The patient population of 40, 50 and 60 year olds find that the need for reading glasses is a frustration.  For patients who have a precription for both myopia and presbyopia there is more to consider when deciding to have LASIK or PRK.  Your doctor can correct your vision fully for distance, but then you will have the need for reading glasses for up close reading, or your doctor can slightly under correct one eye, usually your non-dominant eye for near work and your dominant eye for full distance correction.  This approach allow you to prolong the need for readers.  Every patient responds differently so it is important to do what we refer to as a monovision trial with contact lenses before you have the surgery.



“Monovision via wavefront-guided LASIK ablation to treat myopia in patients with presbyopia produces excellent clinical results and high patient satisfaction, and it has a high safety profile, according to results of a multi-site prospective study presented by Colman R. Kraff, MD, of Chicago.

"If you pay close attention to these patients and their needs, and screen them properly preoperatively, we could achieve the same results [as those of the study]," he said. "This group of patients offers a unique opportunity to grow the refractive population."

In the study, LASIK ablation was performed with a proprietary excimer laser (VISX STAR S4, Advanced Medical Optics). Patients were prescreened by undergoing a contact lens trial to determine their tolerance for monovision, and they also completed a questionnaire to discern their level of understanding of monovision and how realistic their visual goals were.

The study included 296 eyes of 160 patients; 24 fellow eyes did not require laser treatment. Mean patient age was 50 ± 5 years.

At 12 months, 98% of the patients said that they would undergo the procedure again.

"This pre-presbyopic and presbyopic patient population is not the same patient as the Generation X or 30-something group. You need to spend extra time screening," Dr. Kraff said. "And just as important, as the surgeon, you have to believe in monovision, that this really works, in order to make the patients understand what it really is."

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Andrew E. Holzman, MD, FACS

Andrew E. Holzman, MD, FACS, is one of the most well-respected ophthalmologists in the greater Washington, DC, area. He is regularly sought out by professional athletes, media personalities, and other doctors for laser eye surgery. Dr. Holzman is a member of several prestigious organizations, including:

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