ESCRS - POREF181 - Monovision Lasik For Presbyopia In Emmetropes And Hyperopes: How Far Vision Is Preserved In The Near Eye ?

Monovision Lasik For Presbyopia In Emmetropes And Hyperopes: How Far Vision Is Preserved In The Near Eye ?

Published 2026 - 44th Congress of the ESCRS

Reference: POREF181 | Type: Free paper | DOI: 10.82333/0te1-1m68

Authors: Prof. Eric Ernest Gabison* 1 , Dr Natalie Zeghebih 1 , Dr Avinoam Shye Shahar 2 , A/Prof. Michael Mimouni 3 , Dr Daniel LEMAITRE 1

1Ophthalmology ,Rothschild Foundation Hospital,Paris,France, 2Ophthalmology ,Rambam Healthcare Campus,Haifa,Israel, 3Ophthalmology ,Rambam Healthcare Campus,Haifa,Israel;Technion Israel Institute of Technology,Ruth and Bruce Rappaport Faculty of Medicine,Haifa,Israel;Care-Vision Laser Center ,Tel Aviv,Israel

Purpose

To assess uncorrected distance visual acuity (UDVA) in the nondominant (near-targeted) eye after LASIK monovision, and to explore whether corneal asphericity changes (Q-factor) may contribute to distance-vision preservation in hyperopic and emmetropic presbyopes treated with a monovision target.

Setting

Retrospective single-center study of presbyopic hyperopic and emmetropic patients undergoing LASIK monovision. A parallel large monovision cohort including myopic and hyperopic patients is used for comparative analyses using identical endpoints.

Methods

Presbyopic hyperopic and emmetropic patients underwent LASIK monovision using an Alcon WaveLight EX500 excimer laser with a wavefront-optimized ablation profile. The dominant eye was targeted for emmetropia and the nondominant eye for mild myopia (~–1.5 D). Outcomes were collected preoperatively and at 6 months: subjective spherical equivalent (SE), monocular UDVA and UNVA, binocular unaided vision, and Pentacam-derived corneal Q-factor (6-mm zone).

Results

Twenty-seven hyperopic presbyopic patients (54 eyes) were included, mean age 54.7 ± 5.0 years. Preoperative SE was +1.42 ± 0.62 D (dominant) and +1.53 ± 0.62 D (nondominant), with preoperative Q-factor of –0.26 and –0.29, respectively. At 6 months, SE was +0.22 ± 0.41 D (dominant) and –1.67 ± 0.59 D (nondominant). UDVA reached 1.0 (decimal) in the dominant eye and 0.5 in the nondominant eye, while near acuity was P6 (dominant) and P2 (nondominant). Binocularly, 94% of patients achieved 10/10 distance acuity and P2 near acuity without correction. Corneal shape showed a shift toward a more prolate profile in the near-targeted eye, consistent with increased negative asphericity. Similar findings were observed in the larger comparative cohort.

Conclusions

LASIK monovision in hyperopic and emmetropic presbyopes provides high binocular spectacle independence and preserves clinically meaningful distance vision in the nondominant eye despite a myopic target. Corneal asphericity changes toward a more prolate profile may partially explain this functional overlap.