Incidencia y causas de los retratamientos en pacientes miopes intervenidos de LASIK con monovisión inducida, sin prueba preoperatoria de tolerancia de la misma con lentes de contacto

Abstract

Purpose

To evaluate the incidence and causes of the need for retreatment after LASIK-induced monovision in patients with myopia and presbyopia without a previous trial of contact lens induced monovision.

Design

Retrospective, observational study.

Methods

We retrospectively studied 914 eyes of 457 consecutive myopic patients with presbyopia scheduled for LASIK-induced monovision (nondominant eye corrected for near). The dominant eye was identified by the finger pointing test and the treatment plan for the nondominant eye ranged from -0.50 to -1.50 diopters based on an age-related nomogram. We evaluated the incidence of enhancements and the causes at 6 months postoperatively. Patients were divided into three groups based on age to evaluate possible differences in the reasons for retreatment among the age groups.

Results

The global enhancement rate was 15,8% (144/914 eyes). The incidence of retreatment was significantly higher in the dominant eye (8,6%) than in the nondominant eye (7,1%) (P = 0.01). The enhancement rate in the nondominant eye were conversion to full distance (8,8% of patients), induction of more monovision (3,2% of patients) and reduction of anisometropia (1,1% of patients). More young patients (aged 40 to 45 years) wanted to reverse the procedure.

Conclusions

LASIK-induced monovision is a valid option for myopic patients with presbyopia, with a relatively low incidence of enhancements. The low retreatment rate to reverse monovision is a good index of patient tolerance and satisfaction with the results of the procedure. For this reason, a preoperative trial of monovision with contact lenses should not be mandatory before LASIK.