Laser blended vision for presbyopia: six years of experience

Session Details

Session Title: Corneal, Scleral and Pharmaceutical Treatment of Presbyopia

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 16:42

Venue: Meeting Center Room I

First Author: : C.Falcon FRANCE

Co Author(s): :                        

Abstract Details

Purpose:

To study the clinical outcomes of 277 patients with presbyopia that underwent LASIK with a non-linear aspheric ablation profile and micro-monovision for the correction of presbyopia with hyperopia, myopia, astigmatism or emmetropia: Laser Blended Vision (LBV) by Zeiss. It is a wavefront-guided excimer laser treatment which has several mechanisms to increase near vision keeping a good vision for distance as well: micro-monovision, depth of field, spherical aberration, vertex centration, retinal image processing, neural summation, blur adaptation and neural suppression. This makes it an option to consider for presbyopic patients compared to the multifocal intraocular lens implantation.

Setting:

Retrospective study of the first consecutive 277 patients (539 eyes with hyperopia, myopia, astigmatism or emmetropia) that underwent LASIK with the wavefront-guided Laser Blended Vision programme for presbyopia by Carl Zeiss Meditec during the last 6 years in the Eye Clinic: Optima Laser Eye Clinic, Valencia, Spain.

Methods:

The programme has a non-linear aspheric ablation profile that increases the spherical aberration in both eyes. A slight myopia of -1.5 spheres in the non-dominant eye is also programmed. 120 male and 157 female patients between 42 and 71 years old. Only 4.33% were between 42 and 44; 29.96% were between 45 and 49;65,7% were 50 years or more. The follow-up was between 1 to 47 months. 3.15% of eyes were emmetropic, 24.3% were myopic (myopic astigmatic) and 72.54% hyperopic (hyperopic astigmatic). 15 patients underwent the surgery in one eye only.The efficacy, security,predictability and patient's satisfaction were analised.

Results:

97.12% of hyperopic or emmetropic patients had a pre-op near vision between J4 and J10. 99.04% of those patients had a post-op near vision between J1 and J3; 87.98% had J1. 25.37% of myopic patients had a pre-op near vision between J4 and J10. 100% of those patients had a post-op near vision between J1 and J3; 95.52% had J1.For the general group, post-op visual acuity without correction for distance was 20/20 or more: 93.14% (binocular). Predictability (0.5 dioptre) : 87.94%. Security 99.81%. 93.86% satisfied. No severe complications. 35.37% had a follow-up longer than 12 months: 95.92% still satisfied.

Conclusions:

LBV for presbyopia has a high percentage of satisfaction for hyperopic, myopic, astigmatic or emmetropic patients with a fast adaptation and very good outcomes in visual acuity for distance and near. Efficacy, security and predictability are high.The results are as good for younger presbyopic patients as for older ones. Definitely, the patient’s satisfaction improves with the retreatment if needed and it remains high in the long-term follow-up. Satisfaction is not always related to visual acuity, image processing is important to get a confortable vision.LBV is an excellent option for presbyopic patients who prefer to avoid an intraocular procedure.

Financial Disclosure:

NONE