One-year clinical outcomes of PresbyMAX monocular LASIK for presbyopia correction

Xiaoqian Ma; Weijing Yin; Ning Ma; Hongyan Sun; Pengpeng Cai; Qing Li; Wenjuan Liu; Subing Liu; Yuanpei Zhou

doi:10.3760/cma.j.cn115989-20260511-00212

One-year clinical outcomes of PresbyMAX monocular LASIK for presbyopia correction

July 22, 2026

2026，No. 07, Clinical Science, Current Issue, Highlights

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Authors:Ma Xiaoqian, Yin Weijing,Ma Ning, Sun Hongyan, Cai Pengpeng, Li Qing, Liu Wenjuan, Liu Subing, Zhou Yuanpei

Corresponding author:Zhou Yuanpei, Email: zhouyuanpei850405@163.com

Published:2026-07-10

DOI: 10.3760/cma.j.cn115989-20260511-00212

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ABSTRACT

Objective To evaluate the 1-year efficacy and safety of combining conventional corneal refractive surgery in the dominant eye with PresbyMAX monocular laser in situ keratomileusis (LASIK) in the non-dominant eye for the correction of presbyopia with ametropia.

Methods A case series study was conducted. Eighty-nine consecutive patients with presbyopia and ametropia were enrolled in the Zhengzhou Huaxia Pure Vision Eye Hospital from December 22, 2020, to November 20, 2024. Their dominant eyes underwent conventional corneal refractive surgery for full correction of distance vision, while the non-dominant eyes received LASIK under PresbyMAX monocular mode for near vision improvement. Binocular uncorrected distance visual acuity (BUDVA), binocular uncorrected near visual acuity (BUNVA), spherical equivalent (SE), higher-order aberrations, and stereopsis were recorded preoperatively and at 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year postoperatively. The primary endpoint was the stability of efficacy during follow-up, defined as the stability of BUDVA and BUNVA. The secondary endpoints included safety and adverse reactions. Patients were stratified into pre-presbyopia (≤44 years), early presbyopia (45~52 years), and late presbyopia (≥53 years) groups by age to compare postoperative uncorrected visual acuity. The study adhered to the principles of the Declaration of Helsinki. The study protocol was approved by the Institutional Review Board of Zhengzhou Huaxia Pure Vision Eye Hospital (No. ZHSYY-KY-2020-01). Written informed consent was obtained from each participant and their guardian before entering the study cohort.

Results At all postoperative time points, BUDVA and BUNVA were significantly better than preoperatively, with statistically significant differences (all P<0.008). There was no statistically significant difference in BUDVA across time points from 1 week to 1 year postoperatively ( χ ²=4.273, P=0.370). There was no statistically significant difference in BUNVA across time points from 3 months to 1 year postoperatively ( χ ²=3.806, P=0.149). One year after surgery, 80 patients (89.9%) achieved BUDVA ≤0 logMAR, 88 patients (98.9%) achieved ≤0.1 logMAR, and 100% achieved ≤0.2 logMAR. For BUNVA, 76 patients (85.4%) achieved ≤0 logMAR, 85 patients (95.5%) achieved ≤0.1 logMAR, and 87 patients (97.8%) achieved ≤0.2 logMAR. No significant differences were found between preoperative and postoperative corrected distance visual acuity (CDVA) or corrected near visual acuity (CNVA) in both eyes (all P>0.05). Spherical aberration increased significantly in the dominant eye and decreased significantly in the non-dominant eye ( Z=-8.211, -3.127; both P<0.05), while coma, trefoil, and total higher-order aberrations showed no significant changes (all P>0.05). There was no significant difference in the distribution of preoperative and postoperative stereoacuity grades ( H=6.290, P=0.391). At 1 year postoperatively, there was no significant difference in BUDVA among the three presbyopia subgroups ( H=0.999, P=0.607). BUNVA in the pre-presbyopia and early presbyopia groups was significantly better than that in the late presbyopia group (both P<0.017), whereas no significant difference was observed between the pre-presbyopia and early presbyopia groups ( P>0.05). No significant surgery-related adverse events were observed.

Conclusions Conventional corneal refractive surgery on the dominant eye combined with PresbyMAX monocular LASIK on the non-dominant eye demonstrates good efficacy, safety, and stability for correcting presbyopia with concomitant ametropia during the one-year follow-up period. One year postoperatively, BUNVA in pre-presbyopia and early presbyopia patients is superior to that in late presbyopia patients.

KEYWORDS：

Presbyopia; Ametropia; PresbyMAX; Laser in situ keratomileusis; Visual acuity; Refraction; Higher-order aberrations; Stereopsis

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