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Clinical and patient-reported outcomes in a matched comparison of refractive lens exchange using a multifocal IOL and LASIK monovision in presbyopes

Session Details

Session Title: Presbyopia Correction

Session Date/Time: Monday 07/10/2013 | 16:30-18:15

Paper Time: 16:30

Venue: Emerald (First Floor)

First Author: : S.Schallhorn USA

Co Author(s): :    J. Venter              

Abstract Details

Purpose:

To compare two common surgical treatment options for presbyopes

Setting:

Corporate laser center

Methods:

A stratified random matched sample of refractive lens exchange (RLE) and LASIK treatments were selected using the following criteria: (1) surgery was intended to improve near vision while improving or retaining distant vision, (2) age at the time of surgery 45 to 70 yrs, (3) underwent either an RLE procedure with a multi-focal IOL or LASIK monovision, and (4) completed a three month postop examination. Clinical and patient reported outcomes using a psychometric questionnaire were compared.

Results:

There were 1,525 patients in each group and they were well matched. The average age was 54.1 ± 5.0yrs vs 53.8 ± 5.2yrs and the preop sphere was +0.31 ± 2.67D (-10.25 to +4.25) vs +0.31 ± 2.67D (-10.00 to +4.25) for the RLE and LASIK monovision groups, respectively. Clinical outcomes were similar between groups. In particular, binocular uncorrected distant vision (86.7% and 86.4% achieved 20/20) and and uncorrected near vision (88.4% and 87.8% achieved J2 for the RLE and LASIK groups, respectively) were similar (p=0.81). Satisfaction with the procedure and patient reported ability to do daily and physical activities as well as reading were also equivalent. Patient symptoms of dry eye were similar, although the LASIK group reported more artificial tear use. Difficulty with glare and halos around lights at night and night driving problems were more common with the RLE group (p<0.001). 1.3% of the LASIK patient were dissatisfied with the procedure and underwent a reversal of their monovision while 1.4% of RLE patients elected to have a monofocal lens in their second eye because of quality of vision problems with the first eye.

Conclusions:

In this large, well-matched analysis of RLE with a multi-focal lens implantation and LASIK monovision to improve distant and near vision, the clinical outcomes were very similar. There were differences in tear use (favoring RLE) and quality of vision (favoring LASIK monovision). However, patient satisfaction at three months postop was equivalent.

Financial Interest:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented