Abstract

PURPOSE: To compare visual outcome, complications and patient satisfaction of IntralaseLASIK (IL) treatment and conductive keratoplasty (CK) to obtain monovision by treating thenondominant eye in presbyopic emmetropes.SETTING: Reading and Southampton Optimax Laser Eye Clinics, UK.METHODS: Retrospective, consecutive, single-surgeon comparative study of presbyopicemmetropes treated with either IL or CK to achieve monovision by targeting -1.5 dioptre (D)myopia in the non-dominant eye after successful monovision contact lens trial. Thirty-twopatients were treated using CK and 32 patients were treated with IL. The CK treatments were performed with the View Point CK system using the light touch technique. The IL wasperformed using Intralase FS/FS30 and Nidek EC-5000 platform with OPDCAT wavefronttreatment.RESULTS: Spherical Equivalent (SE) at 12 months post procedure was -1.63±0.68 D in theIL group and -0.97±0.82 D in the CK group (p<0.001). The mean vector value ofastigmatism at 12 months post op was 0.32±0.32 D in the IL group and 1.00 ±0.75D in theCK group (p<0.0001). The mean value of induced higher aberration in the IL group was at0.45± 0.28 μm after IL and 1.13±0.25 μm after CK (p< 0.0001). The re-treatment rate was3% after IL and 50% after CK (p<0.0001). Patient satisfaction assessed by a questionnaire at 12 months demonstrated that 63% of subjects were very satisfied after IL compared to 34% after CK (p=0.02).CONCLUSIONS: In emmetropic presbyopes IL monovision provided a stable correction,with less induced astigmatism and HOA. CK monovision cannot be recommended due toregression and induced astigmatism.