We read with great interest the report from Montserrat Garcia-Gonzalez and associates. Their results revealed that monovision is a valid option for myopic patients with presbyopia who are considering LASIK, and good distance and near UCVA (uncorrected visual acuity) can be obtained after LASIK. We are also doing clinical studies about monovision for patient with presbyopia, and we would like to discuss patients’ age with the author.
In their study, patients had to be older than 45 years and the average patient age was 54.1 ± 4.0 years (range, 47–64), while in our practice, there are nearly no myopic patients older than 55 years wanting to correct presbyopia by LASIK. For one thing, they have been used to wearing glasses; for another, older patients tend to have higher incidence of dry eye after corneal refractory surgery, because their glands become atrophic gradually and their healing ability is not as good as it used to be. Moreover, a few of them begin to have cataract. Therefore, intraocular lens–induced monovision in cataract surgery would be better. In our experience, most of the myopic patients between 40 and 45 years of age have presbyopia after full correction by LASIK surgery because of their adjusting ability decreasing. Presbyopia is a serious problem for some of them because they used to be myopic patients. As a result, after LASIK surgery presbyopia should be taken into consideration for these patients.
In our opinion, patient inclusion from 40 to 55 years of age would be more suitable for myopic patients considering LASIK with planned monovision.