Outcomes After Varifocal LASIK for Hyperopic Presbyopia
Narrative Responses:
Purpose
To evaluate the safety and efficacy of Supracor™ (Technolas Perfect Vision GmbH) - an excimer laser in situ keratomileusis (LASIK) algorithm for the treatment of hyperopic presbyopia.
Methods
A retrospective evaluation of 57 eyes of 31 consecutive hyperopic presbyopic patients who received Supracor™. Treatment criteria included age ≥46 years, corrected distance visual acuity (CDVA) in each eye of ≥0.2logMAR, manifest refraction spherical equivalent (MRSE) between +0.75 to +4.00D, ≤2.00D of astigmatism, mean keratometry readings of 41.0-45.0D, ability to tolerate a near addition of >+1.75D, a difference between the MRSE and the cycloplegic refraction of ≤0.75D, CCT of ≥500μm and a mesopic pupil of 3.0-6.0mm. Main outcome measures were safety, efficacy (uncorrected DVA and uncorrected reading ability), predictability, stability, patient satisfaction, and functioning at 6 months.
Results
Mean age was 51 years (44-63 years). The mean preoperative MRSE was +1.04D ± 0.70D. At 6 months, 80% of patients had a binocular UDVA of ≥20/20, and 93% had a binocular UDVA of ≥20/25. The mean MRSE was -0.67 ± 0.63D at 1 month, -0.60 ± 0.72D at 3 months and -0.73D ± 0.56D at 6 months. The CDVA was ≥20/20 for 94% of patients and ≥20/25 for 100% of patients. Ninety four percent had an uncorrected reading ability of ≥20/32. No patients required a retreatment to enhance UDVA.
Conclusion
Supracor™ LASIK for hyperopic presbyopia provides a high level of spectacle independence for near vision whilst improving and maintaining good distance vision. The UDVA outcomes could be improved by a nomogram adjustment to avoid overcorrection. Careful patient selection and counseling is necessary to ensure optimal outcomes and realistic patient expectations.