Comparison of Refractive Lens Exchange With Multifocal IOL and Monovision LASIK in Large Matched Population
Narrative Responses:
Purpose
To evaluate three month clinical and patient reported outcomes between RLE and monovision LASIK
Methods
A random stratified sample of presbyopic patients treated at Optical Express who underwent either an RLE procedure with implantation of a multifocal IOL, with one week between left and right eye surgery, or monovision LASIK. LASIK patients had a successful monovision CL trial before surgery. A clinical examination and patient questionnaire was administered three months after the procedure.
Results
1,525 patients were stratified into each group and were matched for age (mean 54.1 and 53.8 yrs, RLE and LASIK, respectively) and preop refraction (mean preop sphere +0.31 +/- 2.67 for both). Postop binocular UCDVA was the same (p=0.81; 87% and 86% achieved 20/20). There was no difference in procedure satisfaction (p=0.32) or reports of dry eye (p=0.31). The RLE group reported better near vision (p=0.04) but more glare and halos (p<0.001). 1.9% of RLE patients did not proceed with their second eye because of the outcome of their first eye and 1.3% of LASIK patients had their monovision reversed.
Conclusion
In this population, the visual results and patient satisfaction were the same between an RLE procedure with a multifocal IOL or monovision LASIK. The RLE group had more quality of vision symptoms but reported better near vision.