LASIK for Myopic Astigmatism and Presbyopia Using Non-Linear Aspheric Micro-Monovision with the Carl Zeiss Meditec MEL 80 Platform

PURPOSE: to evaluate the monocular and binocular visual outcomes of LASIK with a non-linear aspheric micro-monovision protocol for the correction of myopic astigmatism and presbyopia. METHODS: a retrospective, noncomparative case series included 310 eyes of 155 consecutive patients with myopic astigmatism and presbyopia who were treated with LASIK-induced micro-monovision. The Carl Zeiss Meditec CRS-Master software and MEL 80 excimer laser were used. The target refraction was plano for distance eyes (dominant eye) and between -0.75 and -2.00 diopters (D) for near eyes. Patients were followed for 1 year. Mean attempted spherical equivalent refraction (SE) correction was -3.59 ± 1.79 D (range: -0.20 to -8.31 D). Mean attempted cylinder correction was 0.84 ± 0.63 D (range: 0 to 2.50 D). Median patient age was 49 years (range: 43 to 63 years). Median follow-up was 12.5 months. RESULTS: outcome measures after all treatments were as follows. Achieved SE correction was within ± 0.50 D in 92% and within ± 1.00 D in 99% of eyes. Monocular uncorrected distance visual acuity was 20/20 in 99% and 20/32 in 100% of distance eyes. Binocular uncorrected near visual acuity was J2 in 96% and J5 in 100% of patients. Binocular uncorrected visual acuity was 20/20 and J5 in 99% of patients. No eyes lost 2 or more lines of corrected distance visual acuity. There was no change in mesopic contrast sensitivity (CSV-1000) at all spatial frequencies. The average change in refraction between 3 months and 1 year was -0.0 6± 0.31 D. CONCLUSIONS: this non-linear aspheric myopic micro-monovision protocol was well-tolerated, stable, and effective for treating patients with presbyopia in moderate to high myopic astigmatism.