Refractive Surgery Blog

The US Food and Drug Administration (FDA) finally approved a refractive technique that eye surgeons have commonly used to help presbyopic patients deal with their visual challenges at both distance and near (See my Blog entry "LASIK for Presbyopia," Feb. 13, 2007). Monovision, or the concept of correcting one eye for distance and the other (usually non-dominant eye) for near vision, was approved on July 12, 2007. I have been performing monovision laser refractive surgery on an off-label basis since 1996 and have been correcting patients that way with contact lenses and with intraocular lenses following cataract surgery since 1982. This approach has been widely utilized since the Johnson Administration.

"Monovision has been available off-label since approval of the first laser used for conventional laser eye surgery" according to the Executive Director of the Council for Refractive Surgery Quality Assurance. "This FDA approval is not likely to have any practical effect on the availability of monovision lasik in the United States."

According to the FDA, patients should have a contact lens trial of monovision correction prior to having surgical correction to make sure they tolerate having their eyes corrected to different focal points. The main draw back to to monovision correction is that depth perception may not be as acute as having both eyes corrected equally. Other problem areas arise in driving at night or reading extensively for long periods of time. Some patients elect to wear glasses for those tasks but don't use any additional correction for most daily activities. While we take care to make sure the decision to have monovision correction is the correct one, occasionally a patient will decide it is not what they really wanted. In those rare cases, additional laser treatment can be used to equalize the vision.

Stuart Lewis, MD

Labels: Monovision LASIK