Full range of vision and visual quality after mini-monovision FS-LASIK in high myopic patients with age-related accommodative deficiency

Abstract Background To evaluate clinical outcomes and visual quality 3 months after mini-monovision femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of high myopia in patients with age-related accommodation deficiency. Methods Patients who had mini-monovision FS-LASIK for high myopia (spherical equivalent [SE] < -6.0 D) and aged between 40 and 50 years were included. At the 3-month postoperative visit, we evaluated full range of visual acuity; defocus curve; optical quality; accommodation function, contrast sensitivity and stereopsis. Binocular tests were done twice, once in mini-monovision condition and once with the residual myopia in the non-dominant eye corrected. Subjective visual quality was evaluated with questionnaire. Results Clinical data of 31 cases were analyzed. The average patient age was 42.58 ± 3.06 years. At the 3-month follow-up, the mean uncorrected binocular visual acuity at distance, intermediate, and near was − 0.11 ± 0.07, -0.06 ± 0.10, and 0.04 ± 0.11 logMAR separately. In comparison, full distance correction group achieved better UDVA (P = 0.02), and the monovision group achieved superior UNVA (P = 0.04). FS-LASIK induced significant increases in higher-order aberrations (HOAs) (P < 0.001). For accommodative function, only the negative relative accommodation (NRA) improved significantly after surgery (P < 0.001). A slight decrease in contrast sensitivity was observed at low spatial frequency with monovision (P < 0.05). Questionnaire demonstrated high satisfaction with near vision and visual quality. Conclusion FS-LASIK with mini-monovision appeared to be safe and effective in treating high myopia combined with age-related accommodation deficiency to get satisfying visual quality at distant and at near.