The visual quality of patients with myopia and presbyopia after ICL V4c implantation and FS-LASIK using monovision design.

BACKGROUND

Long-term visual quality of myopes with presbyopia was investigated after implantable collamer lens (ICL) V4c implantation and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery using a monovision design.

METHODS

Fifty-eight patients (116 eyes) were enrolled and average final follow-up time was 55.38 ± 19.38 months. Routine ocular examinations (manifest refraction, axial length, and anterior segment biological parameters), were performed before and after the surgeries. Patients' objective visual quality was evaluated using contrast sensitivity (CS) parameters and signal-to-noise ratio (SNR), while subjective visual quality was assessed using a questionnaire.

RESULTS

ICL and FS-LASIK were successfully performed without complications in all subjects. Binocular visual acuity at near and middle distances remained unchanged; however, at far distances (0.05 ± 0.11 in the ICL group and 0.10 ± 0.23 in the FS-LASIK group, P = 0.02) difference was observed. The CS of dominant eyes were 8.57 ± 2.27 and 7.45 ± 2.68 in the ICL V4c and FS-LASIK groups, respectively (P = 0.550). Moreover, SNR was 5.41 ± 2.10 in the ICL V4c group and 8.00 ± 2.43 in the FS-LASIK group (P < 0.001). CS and visual acuity of the non-dominant eye showed positive correlations at near (B = 3.29, P = 0.037) and far distances (B = 6.649, P = 0.001); however, at moderate distances (B=-3.909, P = 0.023) a negative correlation occurred.

CONCLUSIONS

Both ICL V4c and FS-LASIK provided long-term safety and efficacy for binocular vision in patients with myopia and presbyopia. Correlation between the CS and visual quality of non-dominant eyes at different distances was observed.

KEY MESSAGES

What is known Monovision design for refractive surgeries can effectively correct the refractiveerrors of myopia patients with presbyopia. Binocular imbalance exists in patients after refractive surgery. What is new The visual acuity of the non-dominant eyes at different distances was the mainfactor influencing binocular balance. Correlation between the contrast sensitivity and visual quality of non-dominanteyes at different distances was observed.