The refractive power of my right eye is more than 400 degrees while the power of my left eye is about 100. Is it possible to use Lasik to correct the myopia in my right eye, and leave my left dominant eye for the onset of presbyopia (nearsighted vision) so that I need not wear reading glasses in the future? Also, which Lasik is the safest for my condition: A true no touch Epi-Lasik, Wavefront guided Intralase, Aspehric Lasik or Perfect Cornea Intralase?

Reply by Dr Chua Wei Han
Consultant, Refractive Surgery Service, Singapore National Eye Centre

The technique of correcting one eye for good distance vision while correcting the other eye for near vision is called monovision. This is a well-established and effective method to overcome the need to wear reading glasses in people with presbyopia, an age-related phenomenon that typically occurs in the early 40s.

The majority of people tolerate monovision well and do not notice any shift between distance and near viewing, although some have trouble adjusting to it. Monovision can be applied to glasses, contact lenses, as well as refractive surgical procedures such as Lasik and intraocular lens implantation.

The usual approach in monovision is to select the dominant eye for distance vision and non-dominant eye for near vision. In your case, assuming that the refractive power you have described is myopia (shortsightedness), you may want to consider full correction of the myopia in your left dominant eye but only partial correction in the right non-dominant eye to leave some myopia of between 50 to 200 degrees depending on the severity of your presbyopia and near vision requirements.

As for the various types of laser vision correction techniques you have described, all can be used to achieve monovision. The technique of choice would depend on the findings of a thorough eye assessment performed by your ophthalmologist.