Bojan Pajic1,2,3,4,5, Horace Massa3, Philipp B Baenninger6, Erika Eskina7,8, Brigitte Pajic-Eggspuehler1, Mirko Resan5, Zeljka Cvejic2. 1. Eye Clinic Orasis, Swiss Eye Research Foundation, 5734 Reinach, Switzerland. 2. Department of Physics, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 4, 21000 Novi Sad, Serbia. 3. Department of Clinical Neurosciences, Division of Ophthalmology, Geneva University Hospitals, 1205 Geneva, Switzerland. 4. Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland. 5. Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia. 6. Cantonal Hospital of Lucerne, Department of Ophthalmology, 6006 Lucerne, Switzerland. 7. Ophthalmological Department of Academy of Postgraduate Education FSBF FRCC of the FMBA of Russia, 125310 Moscow, Russia. 8. Laser Surgery Clinic "SPHERE", 117628 Moscow, Russia.
Abstract
BACKGROUND: Presbyopia treatment in pseudophakic patients with a monofocal IOL is challenging. This study investigates the refractive results of femto-PresbyLASIK and analyzes presbyopia treatment in pseudophakic eyes. METHODS: 14 patients with 28 pseudophakic eyes were treated with femto-PresbyLASIK. The dominant eye was targeted at a distance and the non-dominant eye at -0.5 D. The presbyopic algorithm creates a steepness in the cornea center by using an excimer laser that leads to corneal multifocality. RESULTS: 6 months after surgery a refraction of -0.11 ± 0.13 D (p = 0.001), an uncorrected distance visual acuity of 0.05 ± 1.0 logMAR (p < 0.001) and an uncorrected near visual acuity of 0.15 ± 0.89 logMAR (p = 0.001) were achieved in the dominant eye. For the non-dominant eye, the refraction was -0.28 ± 0.22 D (p = 0.002), the uncorrected distance of visual acuity was 0.1 ± 1.49 logMAR, and the uncorrected near visual acuity was 0.11 ± 0.80 logMAR (p < 0.001). Spherical aberrations (Z400) were reduced by 0.21-0.3 µm in 32% of eyes, and by 0.31-0.4 µm in 26% of eyes. CONCLUSION: By steepening the central cornea while maintaining spherical aberrations within acceptable limits, PresbyLASIK created a corneal multifocality that safely improved near vision in both eyes. Thus, femto-PresbyLASIK can be used to treat presbyopia in pseudophakic eyes without performing intraocular surgery.
BACKGROUND: Presbyopia treatment in pseudophakic patients with a monofocal IOL is challenging. This study investigates the refractive results of femto-PresbyLASIK and analyzes presbyopia treatment in pseudophakic eyes. METHODS: 14 patients with 28 pseudophakic eyes were treated with femto-PresbyLASIK. The dominant eye was targeted at a distance and the non-dominant eye at -0.5 D. The presbyopic algorithm creates a steepness in the cornea center by using an excimer laser that leads to corneal multifocality. RESULTS: 6 months after surgery a refraction of -0.11 ± 0.13 D (p = 0.001), an uncorrected distance visual acuity of 0.05 ± 1.0 logMAR (p < 0.001) and an uncorrected near visual acuity of 0.15 ± 0.89 logMAR (p = 0.001) were achieved in the dominant eye. For the non-dominant eye, the refraction was -0.28 ± 0.22 D (p = 0.002), the uncorrected distance of visual acuity was 0.1 ± 1.49 logMAR, and the uncorrected near visual acuity was 0.11 ± 0.80 logMAR (p < 0.001). Spherical aberrations (Z400) were reduced by 0.21-0.3 µm in 32% of eyes, and by 0.31-0.4 µm in 26% of eyes. CONCLUSION: By steepening the central cornea while maintaining spherical aberrations within acceptable limits, PresbyLASIK created a corneal multifocality that safely improved near vision in both eyes. Thus, femto-PresbyLASIK can be used to treat presbyopia in pseudophakic eyes without performing intraocular surgery.
Authors: Dan Z Reinstein; Timothy J Archer; Glenn I Carp; Alastair J Stuart; Elizabeth L Rowe; Andrew Nesbit; Tara Moore Journal: J Refract Surg Date: 2018-02-01 Impact factor: 3.573