Purpose To assess the effectiveness, refractive outcomes, and quality of vision of central presbyopic laser in situ keratomileusis (LASIK) performed with the Custom Q algorithm (Wavelight EX500). Setting Ophthalmology Department, Hôpital de la Timone, Marseille, France. Design Prospective cohort study. Methods This study was performed between February 2013 and January 2015. Patients with hyperopia were treated with central presbyopic LASIK. Distance, near, and intermediate visual acuities; objective and subjective refractions; Q factor; keratometry (K); corneal aberrations, and a quality-of-vision questionnaire were evaluated preoperatively and postoperatively. The dominant eye was treated with standard LASIK for distance vision and the nondominant eye for near vision using a Q factor modulation. Results The study comprised 138 eyes of 28 men and 41 women. The median age was 53.84 years ± 4.2 (SD). One year after surgery, the mean binocular uncorrected distance visual acuity was −0.04 ± 0.05 logMAR (20/20), the mean binocular uncorrected near visual acuity was 0.10 ± 0.08 logMAR (Jaeger 2), and the mean binocular uncorrected intermediate visual acuity was −0.13 ± 0.14 logMAR (20/20). The mean K in nondominant eyes was statistically higher than the mean K in dominant eyes (43.93 ± 1.77 diopters [D] versus 45.85 ± 1.47 D) (P = .002). More than 95% of patients were satisfied 3 months after surgery, and at 6 months, 100% said they would recommend the surgery. Conclusion Central presbyopic LASIK with corneal asphericity modulation using the monovision correction algorithm was effective and safe for presbyopia treatment. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.