Comparison of monovision surgery using ICL V4c or femtosecond laser LASIK for myopia correction in the presbyopia age patients

To compare the long-term outcomes of monovision surgery using implantable collamer lens (ICL) V4c and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in myopic patients with early presbyopia. This case series study included 48 eyes of 24 patients (male/female: 10/14, mean age 45.50 ± 3.82 years) and followed-up for 4.5 years (54.00 ± 9.77 months). Patients were examined for spherical equivalent, uncorrected distance visual acuity, corrected distance visual acuity, intraocular pressure, presbyopic add power, visual acuity (VA) (logMAR) of dominant eyes (D-eye), non-dominant eyes (nD-eye), and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m, corneal wavefront aberration, and contrast sensitivity (CS). All surgeries were uneventful. The safety indices of ICL V4c group and FS-LASIK group were 1.17 ± 0.30 and 0.98 ± 0.20 (p < 0.05), and the efficacy indices were 0.79 ± 0.07 and 0.52 ± 0.07 (p < 0.05) respectively. The binocular VA (logMAR) of ICL V4c group and FS-LASIK group at 5.0 m were: 0.02 ± 0.11, 0.18 ± 0.30; 0.8 m: 0.09 ± 0.12, - 0.01 ± 0.11; 0.4 m: - 0.02 ± 0.06, - 0.03 ± 0.08, (p > 0.05 at three distances). Compared with ICL V4c group, lower CS was observed at 1.0 cpd in the FS-LASIK group (1.07 ± 0.31 vs. 0.80 ± 0.51, p = 0.043). Monovision surgery using ICL V4c and FS-LASIK provides good binocular visual acuity at near-to-far distances in myopia patients in the presbyopia age group.