July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Visual and Patient Reported Outcomes of Monovision LASIK versus Multifocal Intraocular Lens Implantation for the Treatment of Presbyopia
Author Affiliations & Notes
  • Craig Schallhorn
    Flight Surgery, US Navy , San Diego, California, United States
  • Julie Schallhorn
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Steve Schallhorn
    Zeiss, Dublin, California, United States
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Stephen Hannan
    Optical Express, Glasgow, United Kingdom
  • Footnotes
    Commercial Relationships   Craig Schallhorn, None; Julie Schallhorn, None; Steve Schallhorn, Zeiss (E); Stephen Hannan, None
  • Footnotes
    Support  Unrestricted Department Grant From Research to Prevent Blindness
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5757. doi:
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      Craig Schallhorn, Julie Schallhorn, Steve Schallhorn, Stephen Hannan; Visual and Patient Reported Outcomes of Monovision LASIK versus Multifocal Intraocular Lens Implantation for the Treatment of Presbyopia. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5757.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe the visual and patient-reported outcomes of the treatment of presbyopia in patients with refractive lens exchange with multifocal intraocular lens (IOL) placement versus monovision laser in situ keratomileusis (LASIK).

Methods : A retrospective review of patients who underwent LASIK monovision or refractive lens exchange with multifocal IOL placement at a private clinic (Optical Express, Glasgow, UK) between 1/2013 to 1/2016. Patients were included if they were presbyopic (defined as age greater than or equal to 45 years), had a preoperative visual acuity of 20/25 or better, did not have a preoperative diagnosis of other ocular diseases besides cataract in the IOL group, had uncomplicated surgery, and attended a 3 month follow up visit.

Results : A total of 549 patients underwent LASIK with monovision and 429 underwent multifocal IOL placement. Preoperatively, the groups were well matched for age (mean of 52 ± 4 years for LASIK patients versus 55 ± 5 years for IOL patients) and refractive error (average manifest spherical equivalent of +0.73 ± 0.54D for LASIK eyes versus 0.83 ± 0.47 for IOL eyes). Postoperatively, 88.5% of LASIK patients and 87.6% of IOL patients had an uncorrected binocular visual acuity of 20/20 or better, and 98.4% of LASIK patients and 100% of IOL patients had an uncorrected binocular distance acuity of 20/40 or better. Near vision improved by an average of 5.5 ± 2.4 lines of vision in the near targeted eye of LASIK patients and 5.22 ± 2.5 lines of vision in IOL patients. The majority of patients reported they never used distance correction (92.4% of LASIK patients and 88.4% of IOL patients) or near correction (92.0% of LASIK patients and 92.6% of IOL patients) after surgery. A similar number of patients (83.0% of LASIK patients versus 83.9% of IOL patients) reported they were satisfied or very satisfied after surgery. Multifocal IOL patients tended to report more difficulty with glare and halos after surgery, but fewer difficulties with distance vision.

Conclusions : Both refractive lens exchange with multifocal IOL placement and monovision LASIK are viable options for the treatment of presbyopia. Patient visual needs and tolerance of postoperative visual symptoms may help guide procedure selection.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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