One-Year Experience of Presbyopia Correction With Monovision Approach in Surface Ablation Using Multifocal Bi-Aspheric Ablation Profile
Narrative Responses:
Purpose
To evaluate the postoperative clinical outcomes in terms of binocular and monocular uncorrected visual acuities, visual quality, and the change in high order aberrations, among presbyopic eyes that have underwent alcohol-assisted PRK. PresbyMAX µ-Monovision bi-aspheric treatments have been bilaterally performed in all cases.
Methods
Sixteen presbyopic patients (32 eyes) (48±5 years, range 41 to 59) with SEQ -6.25D to +4.5D and astigmatism up to 2.00D with surgical add 1.75D to 2.25D were analyzed at six-month and one-year – six myopic patients and ten hyperopic patients. PresbyMAX µ-Monovision bi-aspheric treatments were planned with Custom Ablation Manager software and ablations performed using the SCHWIND AMARIS flying-spot excimer laser system (both SCHWIND eye-tech-solutions). PRK with use of Mitomycin C has been carried out in all cases. Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, visual acuity, and contrast sensitivity.
Results
At 6-month postop myopes showed the SEQ -0.35D±0.30D in distance-eye (DE) and -1.07D±0.31D in near-eye (NE). Residual cylinder was -0.10D±0.20D (DE) and -0.35D±0.30D (NE). Uncorrected-distance-visual-acuity (UDVA) was 20/22±2letters (DE) and 20/33±5letters (NE). Uncorrected-near-visual-acuity (UNVA) demonstrated 0.15±0.07logRAD (DE) and 0.08±0.04logRAD (NE). Hyperopes showed the SEQ -0.79D±0.66D (DE) and -1.49D±0.78D (NE). Residual cylinder was -0.33D±0.35D (DE) and -0.18D±0.28D (NE). UDVA was 20/33±9letters in DE and 20/45±12letters in NE. UNVA demonstrated 0.24±0.19logRAD (DE) and 0.12±0.06logRAD (NE). The targeted anisometropia of 0.75D between DE and NE was almost achieved. Contrast sensitivity slightly decrease at high spatial frequencies.
Conclusion
Near vision increases fast with PresbyMAX PRK. Recovery in distance acuity took up to three months in presbyopic myopes, even longer in presbyopic hyperopes (a more negative distance refraction at six-month). The results showed us the safety of the method and near spectacle independence in almost all cases.