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Pre and postoperative evaluations (1 week, 1, 3, and 6 months) included uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance visual acuity (CDVA). Corneal aberration and Strehl ratio (SR) were analyzed within 3-mm and 6-mm zones. The National Eye Institute 25-Item Visual Function Questionnaire (NEI-VFQ-25) was used to assess visual function preoperatively and at 6 months postoperatively.<\/jats:p>\n <\/jats:sec>\n \n Result<\/jats:title>\n \n At 6 months, binocular UDVA and UIVA were 0 (\u2212\u20090.1, 0) logMAR and \u2212\u20090.1 (\u2212\u20090.1, 0) logRAD, respectively. Spectacle independence reached 96%, with 96%, 100%, and 96% achieving UDVA\u2009\u2265\u20090.1 logMAR, UIVA\u2009\u2265\u20090.1 logRAD, and UNVA \u2265J1. No eyes lost corrected distance visual acuity. In non-dominant eyes, 3-mm corneal zones exhibited negative shifts in fourth-order spherical aberration (\n \n $${Z}_{4}^{0}$$<\/jats:tex-math>\n <\/jats:inline-formula>\n ) and sixth-order spherical aberration (\n \n $${Z}_{6}^{0}$$<\/jats:tex-math>\n <\/jats:inline-formula>\n ) (both\n p<\/jats:italic>\n \u2009<\u20090.001). In 6-mm corneal zones,\n \n $${Z}_{4}^{0}$$<\/jats:tex-math>\n <\/jats:inline-formula>\n exhibited no significant change; however, compared to the dominant eye, it was significantly more negative (\n p<\/jats:italic>\n \u2009<\u20090.001).\n \n $${Z}_{6}^{0}$$<\/jats:tex-math>\n <\/jats:inline-formula>\n increased positively with a statistically significant difference (\n p<\/jats:italic>\n \u2009<\u20090.001). NEI-VFQ-25 scores improved from 74.63 (71.70, 81.81) to 91.15 (85.23, 93.08) (\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The PresbyMAX protocol enhances near vision by strategically manipulating aberrations to increase depth of focus in the non-dominant eye, while the dominant eye maintains distance and intermediate vision. This synergistic binocular approach achieves satisfactory full-range vision, resulting in a 96% spectacle independence rate and high patient satisfaction.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration number<\/jats:title>\n ChiCTR2300074821, registration date 2023-08-17.<\/jats:p>\n <\/jats:sec>","DOI":"10.1186\/s12886-026-04741-9","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:44:48Z","timestamp":1774424688000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in visual acuity and corneal aberrations after presbyopia correction using micro-monovision multifocal bi-aspheric ablation: six-month results"],"prefix":"10.1186","volume":"26","author":[{"given":"Xiaofan","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinuo","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8058-3696","authenticated-orcid":false,"given":"Peng","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suqi","family":"Xian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongsheng","family":"Bi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"4741_CR1","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.preteyeres.2018.09.004","volume":"68","author":"JS Wolffsohn","year":"2019","unstructured":"Wolffsohn JS, Davies LN, Presbyopia. 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