AIM: To observe the clinical efficacy between SMILE and FS-LASIK with monovision design to treat the presbyopia.

METHODS: According to the methods of operation, the presbyope with myopia were divided into two groups, who received the treatment with monovision design. SMILE group had 10 patients(20 eyes),the average age were 45±2.83 years old and myopia degree was -5.42±1.74D. FS-LASIK group had 9 patients(18 eyes), the average age were 45±1.97 years old and myopia degree was -5.60±1.84D. The far vision and the near vision of monocular and binocular of preoperative and postoperative between two groups were observed.

RESULTS: SMILE group in preoperative: the preoperative subjective eye's far visual acuity was 0.05±0.04, the subjective eye's near vision was 0.36±0.15; the objective eye's far visual acuity was 0.35±0.11, the objective eye's near visual acuity was 0.16±0.11; the binocular far visual acuity was 0.05±0.05 and the binocular near visual acuity was 0.18±0.09. Preoperative FS-LASIK group: preoperative subjective eye's far visual acuity was 0.09±0.09, subjective eye's near vision was 0.42±0.17; the objective eye's far visual acuity was 0.44±0.11, the objective eye's near visual acuity was 0.19±0.10; the binocular far visual acuity was 0.03±0.04 and the binocular near visual acuity was 0.19±0.11. The result of before surgery between the two groups had no statistical difference(P﹥0.05). Postoperative SMILE group: the far visual acuity of subjective eye was -0.01±0.06, the near vision of subjective eye was 0.32±0.14; the far visual acuity of objective eye was 0.16±0.18, the near visual acuity of objective eye was 0.12±0.12; the binocular far visual acuity was -0.04±0.07, the binocular near visual acuity was 0.10±0.11. Postoperative FS-LASIK group: the far visual acuity of subjective eye was 0.03±0.03, the near vision of subjective eye was 0.45±0.13; the far visual acuity of objective eye was 0.20±0.15, the near visual acuity of objective eye was 0.24±0.12; the binocular far visual acuity was 0.01±0.03 and the binocular near visual acuity was 0.22±0.09. The comparisons of after surgery between the two groups were statistical differences in the binocular far vision(t= -2.383, P=0.034), and the binocular near vision(t= -2.424, P=0.027). The vision comparisons between preoperative and postoperative in SMILE group, there were all statistically significant in the far visual acuity of subjective eye(t=3.914, P=0.004), the far visual acuity of objective eye(t=4.894, P=0.001), the binocular far visual acuity(t=4.870, P=0.001)and the binocular near visual acuity(t=2.388, P=0.041). That means the vision of postoperative was better than the expected vision before operation. The far visual acuity of objective eye were compared between preoperative and postoperative in FS-LASIK group, the differences was statistically significant(t=4.068, P=0.004).

CONCLUSION: To presbyope with myopia, the treatment of SMILE and FS-LASIK all can get expected results with monovision design. But the patients after SMILE would have better binocular far vision and binocular near vision than after FS-LASIK.