Abstract
BackgroundTo investigate the safety and optical quality of small-incision lenticule extraction (SMILE) combined with monovision, and patient satisfaction with the procedure.MethodsThe present study assessed a non-random case series involving 60 eyes of 30 patients (mean age 45.53 ± 3.20 years [range 41 to 52 years]) treated bilaterally using the VisuMax 500 system (Carl Zeiss Meditec, Jena, Germany) between January and July 2016. The target refraction was plano for the distance eye, and between − 0.5 and − 1.75 diopters (D) for the near eye. Visual acuity, refraction errors, ocular aberrations, and satisfaction questionnaire scores were calculated 1 year after surgery.ResultsAll surgeries were uneventful, with a mean safety index of 1.03 and 1.04 in dominant and nondominant eyes, respectively. Binocular uncorrected distance visual acuity of all patients was ≥20/32, while binocular uncorrected near visual acuity was ≥20/40 1 year postoperatively. Higher-order aberration (0.45 ± 0.14, 0.51 ± 0.15 μm), spherical (0.18 ± 0.15, 0.21 ± 0.14 μm) and coma aberration (0.31 ± 0.16, 0.27 ± 0.17 μm) were identical between dominant and nondominant eyes after surgery. The overall satisfaction rate was 86.7% (26/30), with large contributions from age (OR = 1.76 95% CI: 1.03–2.53; P = 0.036). Binocular uncorrected distance visual acuity was related to preoperative spherical diopter (r = − 0.500; P = 0.005).ConclusionsMonovision appears to be a safe and effective option for myopia patients with presbyopia who are considering the SMILE procedure. Patients with younger age were more satisfied with the procedure.
Highlights
To investigate the safety and optical quality of small-incision lenticule extraction (SMILE) combined with monovision, and patient satisfaction with the procedure
We examined monovision combined with small incision lenticule extraction (SMILE) to investigate its efficacy, safety, and patient satisfaction over a long-term follow-up period
Monovision excimer laser correction has a considerable history in photorefractive keratectomy and laser-assisted in situ keratomileusis (LASIK), various degrees of satisfaction have been reported in previous studies [9, 10]
Summary
To investigate the safety and optical quality of small-incision lenticule extraction (SMILE) combined with monovision, and patient satisfaction with the procedure. Several surgical methods are used to correct presbyopia, including the excimer laser procedure, conductive keratoplasty, intrastromal femtosecond ring incisions, and pseudophakic multifocal intraocular lens [2]. Each procedure has advantages and disadvantages; surgical correction of presbyopia remains a major. With advances in refractive surgery technology, small incision lenticule extraction (SMILE) is becoming more prevalent due to its excellent safety, efficiency, and good preservation of corneal biomechanics [6, 7]. Fu et al BMC Ophthalmology (2018) 18:131 of our knowledge, few reports have described visual outcomes of monovision induced by SMILE in myopic patients with presbyopia [8]. We examined monovision combined with SMILE to investigate its efficacy, safety, and patient satisfaction over a long-term follow-up period
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