Ocular dominance and stereopsis as crucial assessment in presbyopia refractive surgery

Correspondence Ocular Dominance and Stereopsis as Crucial Assessment in Presbyopia Refractive Surgery Authors 1. Sánchez-González, José-María OD, PhD a 2. De-Hita-Cantalejo, Concepción OD, PhD a 3. Sánchez-González, María Carmen OD, PhD a a Department of Physics of Condensed Matter, Optics Area. University of Seville, Seville, Spain. Corresponding author Sánchez-González, José-María, OD, PhD, University of Seville Reina Mercedes St., Physic Faculty, University of Seville, Seville, Spain +34 618 20 41 10 / [email protected] Source of Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The corresponding author is who receives reprints. Cover Letter / Title Page 1 We read with interest the study by Rahmania et al.1 in the January 2021 issue emphasizing the 1 superiority of enhanced depth of focus using negative spherical aberration modulation in the non- 2 dominant eye compared with contact lens monovision. They also demonstrate the effectiveness of 3 positive spherical aberration induction to improve intermediate and near vision in the dominant eye. 4 Regarding preoperative methodological assessment we want to focus on ocular dominance procedure. 5 The authors explored ocular dominance with the pinhole test and the lens fogging technique. Later in 6 the surgical procedure, authors stated that for the dominant eye, distance vision was corrected with a 7 target refraction of +0.50 diopters and in the non-dominant eye, the target refraction was -2.50 D. 8 9 Hole-in-card test for motor ocular dominance and +1.00 diopters lens fogging technique were the most 10 effective test to choice dominant and non-dominant eye for presbyopia refractive surgery.2 However, it 11 seems not only to determine right of left dominance, although the point is to exclude those refractive 12 candidates with strong or clear dominance. Seijas et al.2 concluded that no clear ocular dominance 13 occurred in their study population. In addition, the dominant eye changed, in the same subject, 14 depending on the test used. Jain et al.3 described monovision results and subject satisfaction rate along 15 with standard monovision (dominant eye adjusted for distance) and crossed monovision (dominant eye 16 adjusted for near). They found that both groups obtained similar visual and refractive outcomes and 17 satisfaction rate seems to have no difference. Moreover, Handa et al.4 found that binocular summation 18 failed on patient with strong ocular dominance after adding positive spherical lens in front of one eye. 19 Therefore, dominance preoperative examination may lie in determining the potential dominance 20 magnitude rather than whether the dominant is the right or left eye. 21 Another highlight would be the stereoacuity assessment, Alarcón et al.5 performed presbyopic refractive 22 surgery on twenty-five patients within the dominant eye corrected for distance vision and the non- 23 dominant eye for near vision but with the half myopic target in the near eye than Rahmania et al.1 study. 24 Alarcón and colleagues5 found a contrast sensitivity and stereoacuity significant decrease after 25 presbyopia refractive procedure. This implies a binocular summation loss and consequently a decrease 26 in the visual quality achieved after refractive surgery. In this case, the stereoacuity data would be a key 27 Manuscript 2 information in the potential success surgery prediction. Finding information on this variable in 28 Rahmania et al.1 manuscript would have been very suitable. 29 30 In conclusion, extensive ocular dominance and stereopsis preoperative assessment appear to be critical 31 to achieve success rate on visual, refractive and satisfaction outcomes on presbyopia refractive surgery. 32 In the same way, we would like to congratulate the authors for the excellent results obtained. 33 34 References 35 1. Rahmania N, Salah I, Rampat R, Gatinel D. Clinical Effectiveness of Laser-Induced Increased 36 Depth of Field for the Simultaneous Correction of Hyperopia and Presbyopia. J Refract Surg. 37 2021;37(1):16-24. doi:10.3928/1081597X-20201013-03 38 2. Seijas O, Gómez de Liaño P, Gómez de Liaño R, Roberts CJ, Piedrahita E, Diaz E. Ocular 39 Dominance Diagnosis and Its Influence in Monovision. Am J Ophthalmol. 2007;144(2). 40 doi:10.1016/j.ajo.2007.03.053 41 3. Jain S, Ou R, Azar DT. Monovision outcomes in presbyopic individuals after refractive 42 surgery. Ophthalmology. 2001;108(8):1430-1433. doi:10.1016/S0161-6420(01)00647-9 43 4. Handa T, Shimizu K, Mukuno K, Kawamorita T, Uozato H. Effects of ocular dominance on 44 binocular summation after monocular reading adds. J Cataract Refract Surg. 2005;31(8):1588- 45 1592. doi:10.1016/j.jcrs.2005.01.015 46 5. Alarcón A, Anera RG, Villa C, Jiménez Del Barco L, Gutierrez R. Visual quality after 47 monovision correction by laser in situ keratomileusis in presbyopic patients. J Cataract 48 Refract Surg. 2011;37(9):1629-1635. doi:10.1016/j.jcrs.2011.03.042 49 50