The Korean Journal of Vision Science (대한시과학회지)

The Korean Society of Vision Science (대한시과학회)
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Visual Outcomes of Monovision Keratorefractive Surgery in Presbyopic Patients

모노비전 각막굴절교정 노안 수술 후 시기능 평가

  • Min, Ji-Young (Gangnam Dream Eye Center) ;
  • Lee, Koon-Ja (Dept of Optometry, Graduate School of Health Science, Eulji University)
  • 민지영 (강남드림성모안과) ;
  • 이군자 (을지대학교 보건대학원 안경광학과)
  • Received : 2018.07.28
  • Accepted : 2018.09.21
  • Published : 2018.09.30
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Abstract

Purpose : To assess the change of binocular visual function and visual acuity in monovision surgery patients. Methods : The subjects were 58($49.57{\pm}3.27years$) monovision patients who wear glasses and contact lens before monovision surgery. 100% and 10% contrast visual acuity, near stereoacuity, distance and near convergence fused amplitude, amplitude of accommodation were measured and visual satisfaction in the real life after surgery was evaluated using a Questionnaire. All measurements were conducted before and after 1, 3 and 6 months of surgery. The pre-operative measurements were performed with glasses or contact lenses on, and post-operative measurements were conducted in the naked eye. All measurements among groups were statistically analyzed with the SPSS 21.0. Results : Among 58 subjects, 5 subjects (10 eyes) were hyperopia, 53 subjects (106 eyes) were myopia. Binocular distance and near contrast visual acuity was decreased after surgery, especially the 10 % contrast visual acuity under mesopic condition was decreased and there was no difference according to the postoperative period. In the questionnaire survey, satisfaction of distance and near vision after surgery was getting better, and night glare was worsen compare to pre-operation, however, general satisfaction was high after surgery. The near stereoacuity and distance convergence fused amplitude were decreased, and no changes in near sensory suppression and near convergence fused amplitude, and the amplitude of accommodation was increased in binocular and non-dominant eye after monovision surgery. Conclusion : The visual acuity, near stereoacuity and distance convergence fused amplitude were decreased after monovision surgery compared to progressive glasses multifocal contact lens wear, however, visual satisfaction in real life was improved.

목적 : 모노비전 시력교정 수술을 받은 노안을 대상으로 수술 후 시력과 양안시기능 변화를 평가하였다. 방법 : 모노비전 노안교정 수술(라식 또는 라섹)을 받은 환자 58명($49.57{\pm}3.27$세)을 대상으로 하였다. 시기능은 100% 및 10% 대비시력, 근거리 입체시, 원 근거리 폭주융합력과 조절력을 측정하였으며, 실생활에서 느끼는 시각적 만족도는 설문조사를 이용하여 평가하였다. 수술 전 검사는 안경이나 콘택트렌즈를 착용한 상태에서 측정하였고, 수술 후에는 1, 3, 6 개월 후에 측정하였으며, 검사값은 SPSS 21.0을 이용하여 분석하였다. 결과 : 대상자 58명 중 원시안은 5명(10안), 근시안은 53명(106안)이었다. 수술 후 양안 원거리 및 근거리 시력은 수술 전보다 저하되었고, 특히 박명시 상태에서 10 % 대비시력은 크게 감소하였으며, 수술 1개월 후 부터는 경과기간에 따라서 차이가 없었다. 설문조사 결과에서는 수술 후 원거리와 근거리 시력 만족도는 향상되었고, 야간 빛번짐이 불편사항으로 나타났으나 전반적인 만족도는 높았다. 모노비전 수술 후 근거리 입체시와 원거리 폭주융합력은 감소하였고, 근거리 억제와 근거리 폭주융합력은 차이가 없었으며, 양안과 비우세안의 조절력은 증가하였다. 결론 : 모노비전 각막굴절교정 수술 후 시력, 근거리 입체시와 원거리 융합력은 안경이나 콘택트렌즈 착용시보다 감소하였지만 시생활에서 시각적 만족도는 높게 나타났다.

Keywords

References

  1. Evans BJW: Monovision: a review. Ophthalmic Physiol Opt. 27(5), 417-439, 2007. https://doi.org/10.1111/j.1475-1313.2007.00488.x
  2. Alarc n A, Anera RG et al: Visual quality after monovision correction by laser in situ keratomileusis in presbyopic patients. J Cataract Refract Surg. 37(9), 1629-1635, 2011. https://doi.org/10.1016/j.jcrs.2011.03.042
  3. Levinger E, Trivizki O et al: Monovision surgery in myopic presbyopes : visual function and satisfaction. Optom Vis Sci. 90(10), 1092-1097, 2013. https://doi.org/10.1097/OPX.0000000000000002
  4. Jain S, Ou R et al: Monovision outcomes in presbyopic individuals after refractive surgery. Ophthalmology 108(8), 1430-1433, 2001. https://doi.org/10.1016/S0161-6420(01)00647-9
  5. Goldberg DB. Laser in situ keratomileusis monovision. J Cataract Refract Surg. 27(9), 1449-1455, 2001. https://doi.org/10.1016/S0886-3350(01)01001-X
  6. Miranda D, Krueger R: Monovision laser in situ keratomileusis for pre-presbyopic and presbyopic patients. J Refract Surg. 20(4), 325-328, 2004.
  7. Barrett BT, Bradley A et al.: The relationship between anisometropia and amblyopia. Prog Retin Eye Res. 36, 120-158, 2013. https://doi.org/10.1016/j.preteyeres.2013.05.001
  8. Collins MJ, Bruce AS: Factors influencing performance with monovision. Contact lens Anterior Eye 17(3), 83-89, 1994.
  9. Brooks SE, Johnson D et al.: Anisometropia and binocularity. Ophthalmology 103(7), 1139-1143, 1996. https://doi.org/10.1016/S0161-6420(96)30555-1
  10. Tomac S, Birdal E: Effects of anisometropia on binocularity. J Pediatr Ophthalmol Strabismus 38(1), 27-33, 2001.
  11. Handa T, Mukuno K et al.: Ocular dominance and patient satisfaction after monovision induced by intraocular lens implantation. J Cataract Refract Surg. 30(4), 769-774, 2004. https://doi.org/10.1016/j.jcrs.2003.07.013
  12. Jain S, Ou R et al.: Monovision outcomes in presbyopic individuals after refractive surgery. Ophthalmology 108(8), 1430-1433, 2001. https://doi.org/10.1016/S0161-6420(01)00647-9
  13. Schor C, Erickson P: Patterns of binocular suppression and accommodation in monovision. Am J Optom Physiol Opt. 65(11), 853-861, 1988. https://doi.org/10.1097/00006324-198811000-00001
  14. Erickson P, McGill EC: Role of visual acuity, stereoacuity, and ocular dominance in monovision patient success. Optom Vis Sci. 69(10), 761-764. 1992. https://doi.org/10.1097/00006324-199210000-00003
  15. Fernandes PR, Neves HI et al.: Adaptation to multifocal and monovision contact lens correction. Optom Vis Sci. 90(3), 228-235, 2013. https://doi.org/10.1097/OPX.0b013e318282951b
  16. Rajagopalan AS, Bennett ES et al.: Visual performance of subjects wearing presbyopic contact lenses. Optom Vis Sci. 83(8), 611-615, 2006. https://doi.org/10.1097/01.opx.0000232185.00091.45
  17. Seo CY, Ryu GC: Changes in visual function according to the addition of center-near designed multifocals and utilization as contact lenses for fatigue. Korean J Vis Sci. 20(1), 69-76, 2018. https://doi.org/10.17337/JMBI.2018.20.1.69
  18. Lee AY, Lee KJ: Effect of induced accommodation relaxation methods on visual function in young adults. Korean J Vis Sci. 18(3), 321-332, 2016. https://doi.org/10.17337/JMBI.2016.18.3.321
  19. Erickson P, McGill EC: Role of visual acuity, stereoacuity and ocular dominance in monovision patient success. Optom Vis Sci. 69(10), 761-764, 1992. https://doi.org/10.1097/00006324-199210000-00003
  20. McDonnell PJ, Lee P et al.: Associations of presbyopia with vision-targeted health-related quality of life. Arch Ophthalmol. 121(11), 1577-1581, 2003. https://doi.org/10.1001/archopht.121.11.1577
  21. Wright KW, Guemes A et al.: Binocular function and patient satisfaction after monovision induced by myopic photorefractive keratectomy. J Cataract Refract Surg. 25(2), 177-182, 1999. https://doi.org/10.1016/S0886-3350(99)80123-0
  22. Godts D, Tassignon MJ et al.: Binocular vision impairment after refractive surgery. J Cataract Refract Surg. 30(1), 108-116, 2003.
  23. Farid M, Steinert RF: Patient selection for monovision laser refractive surgery. Curr Opin Ophthalmol. 20(4), 251-254, 2009. https://doi.org/10.1097/ICU.0b013e32832a0cdb
  24. Garcia-Gonzalez M, Teus MA et al.: Visual outcomes of LASIK-induced monovision in myopic patients with presbyopia. Am J Ophthalmol. 150(3), 381-386, 2010. https://doi.org/10.1016/j.ajo.2010.03.022
  25. Lee HY, Her J: Clinical evaluation of monovision after cataract surgery. J Korean Ophthalmol Soc. 49(9), 1437-1442, 2008. https://doi.org/10.3341/jkos.2008.49.9.1437
  26. Marran L, Schor CM: Lens induced anisoaccommodation. Vision Res. 38(22), 3601-3619, 1998. https://doi.org/10.1016/S0042-6989(98)00064-9
  27. Lee D, Wie H et al.: Refraction before and after LASIK. J Korean Ophthalmol Soc. 44(11), 2585-2590, 2003.
  28. Reilly CD, Lee WB et al.: Surgical monovision and monovision reversal in LASIK. Cornea 25(2), 136-138, 2006. https://doi.org/10.1097/01.ico.0000178722.19317.7b
  29. Kim JM, Lee MA: Comparison of contrast sensitivity between soft contact lens wearers and spectacle wearers. J Korean Opthalmic Opt Soc. 12(4), 119-125, 2007.
  30. Schwarz C, Manzanera S, et al.: Comparison of binocular through-focus visual acuity with monovision and a small aperture inlay. Biomed Opt Express 5(10), 3355-3366, 2014. https://doi.org/10.1364/BOE.5.003355
  31. Collins M, Goode A et al.: Distance visual acuity and monovision. Optom Vis Sci. 70(9), 723-728, 1993. https://doi.org/10.1097/00006324-199309000-00007
  32. Chu BS, Wood JM et al.: Effect of presbyopic vision corrections on perceptions of driving difficulties. Eye Contact Lens 35(3), 133-143, 2009. https://doi.org/10.1097/ICL.0b013e3181a1435e
  33. Romano PE, Romano JA et al.: Stereoacuity development in children with normal binocular single vision. Am J Ophthalmol. 79(6), 966-971, 1975. https://doi.org/10.1016/0002-9394(75)90679-0
  34. Back A, Grant T et al.: Comparative visual performance of three presbyopic contact lens corrections. Optom Vis Sci. 69(6), 474-480, 1992. https://doi.org/10.1097/00006324-199206000-00011
  35. Heo JW, Yoo KW: Effect of experimentally induced anisometropia on binocular vision. J Korean Ophthalmol Soc. 40(12), 3468-3473, 1999.
  36. Park MG, Jin YH: Effect of induced anisometropia on stereoacuity by far and near distance random dot stereo test. J Korean Ophthalmol Soc. 37(5), 862-870, 1996.
  37. Singh D, Saxena R et al.: Stereoacuity changes after laser in situ keratomileusis. Optom Vis Sci. 92(2), 196-200, 2015. https://doi.org/10.1097/OPX.0000000000000468
  38. Oguz H, Oguz V: The effects of experimentally induced anisometropia on stereopsis. J Pediatr Ophthalmol Strabismus 37(4), 214-218, 2000.
  39. Larson W, Lachance A: Stereoscopic acuity with induced refractive errors. Am J Optom Physiol Opt. 60(6), 509-513, 1983. https://doi.org/10.1097/00006324-198306000-00011
  40. Wright KW, Guemes A et al.: Binocular function and patient satisfaction after monovision induced by myopic photorefractive keratectomy. J Cataract Refract Surg. 25(2), 177-182, 1999. https://doi.org/10.1016/S0886-3350(99)80123-0
  41. Schor C, Erickson P: Patterns of binocular suppression and accommodation in monovision. Am J Optom Physiol Opt. 65(11), 853-861, 1988. https://doi.org/10.1097/00006324-198811000-00001
  42. Bharadwaj SR, Candy TR: Cues for the control of ocular accommodation and vergence during postnatal human development. J Vis. 8(16), 14.1-1416, 2008. https://doi.org/10.1167/8.16.14
  43. Ito M, Shimizu K et al.: Assessment of visual performance in pseudophakic monovision. J Cataract Refract Surg. 35(4), 710-714, 2009. https://doi.org/10.1016/j.jcrs.2008.12.019
  44. Goldberg DB. Laser in situ keratomileusis monovision. J Cataract Refract Surg. 27(9), 1449-1455, 2001. https://doi.org/10.1016/S0886-3350(01)01001-X
  45. Schor C, Landsman L et al.: Ocular dominance and the interocular suppression of blur in monovision. Am J Optom Physiol Opt. 64(10), 723-730, 1987. https://doi.org/10.1097/00006324-198710000-00002