Incidence and causes of retreatments after monovision induced by LASIK in myopic patients without a previous trial of contact lens induced monovision.

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 = .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 40-45 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.