Experience with Patient Experience with Patient Satisfaction with Monovision Satisfaction with Monovision Targeted in PRK and LASIKTargeted in PRK and LASIK

C R Shah MDM K Purba ODA Dardzhikova MDJ A van Westenbrugge MDH V Gimbel MD MPH Gimbel Eye Centre Calgary AB

ASCRS San Francisco 2009Authors have no financial interest

PurposeTo describe the incidence of monovision choice among PRK and LASIK patients in three surgeon populations (HVG, JAV, JK) at the Gimbel Eye Centre

Monovision in PRK and LASIKMonovision in PRK and LASIK

MethodsE-medical records, retrospective

Captured data included eye dominance and targeted SE in either PRK or LASIK surgery

Monovision candidates underwent monovision trial

Routine pre-op and post-op visual and refractive data recorded

The incidence of retreatment to reverse monovision was analyzed

Monovision in PRK and LASIKMonovision in PRK and LASIK

1.90%

1.32%

1.69%

0

0.5

1

1.5

2 HVG

JAV

JK

Overall Incidence of Monovision in PRK Eyes 2002-2008 n=153 (1.53%)

%

n=21/1103 n=68/5141 n=64/3787

Monovision in PRK and LASIKMonovision in PRK and LASIK

Age and Targeted SE in Monovision PRK Eyes 2002-2008 n=153

years SE

Monovision in PRK and LASIKMonovision in PRK and LASIK

4.76%

2.94%3.12%

0

1

2

3

4

5 HVG

JAV JK

Incidence of Monovision Reversal in PRK Eyes 2002-2008 n=5 out of 153 Patients who underwent

Monovision (3.27%)

n=1/21 n=2/68 n=2/64

%

Monovision in PRK and LASIKMonovision in PRK and LASIK

2.16%

1.50% 1.41%

0

0.5

1

1.5

2 HVG

JAV JK

Overall Incidence of Monovision in LASIK/IntraLASIK Eyes 2002-2008

n=227 (1.58%)

%

n=51/2359 n=101/6743 n=75/5330

Monovision in PRK and LASIKMonovision in PRK and LASIK

Age and Targeted SE in Monovision LASIK/IntraLASIK Eyes 2002-2008 n=227

yearsSE

Monovision in PRK and LASIKMonovision in PRK and LASIK

7.84%

3.96%4.00%

0

1

2

3

4

5 HVG

JAV JK

Incidence of Monovision Reversal in LASIK /IntraLASIK Eyes 2002-2008 n=11 out of 227 Patients who underwent Monovision (4.85%)

n=4/51 n=4/101 n=3/75

%

Monovision in PRK and LASIKMonovision in PRK and LASIK

Overall Incidence of Monovision in PRK and LASIK 2002-2008

n=380 (1.55%)

n=380/24463

Incidence of Monovision Reversal in PRK and LASIK Patients who Underwent Monovision 2002-2008

n=16 (4.21%)

n=16/380

Monovision in PRK and LASIKMonovision in PRK and LASIK

Monovision in PRK and LASIKMonovision in PRK and LASIK

DiscussionMedian age (49 years) for monovision patients was similar among the 3 surgeons, as was targeted SE (-1.50D)

No inclusion criteria was used except for the patient’s strong motivation for monovision including monovision pre-op trial: this self-selected patient population showed over a 95% success rate for achievable and acceptable monovision in refractive surgery

The importance of preoperative education and monovision trial, including patient motivation and self-selection cannot be overemphasized

ConclusionGiven patient age and visual needs, monovision is a highly successful surgical option among refractive patients, especially after a thorough educational and informed consent process and preoperative monovision trial.

Monovision in PRK and LASIKMonovision in PRK and LASIK