Laser refractive correction in presbyopic myopes and presbyopic hyperopes with application of a bi-aspheric multifocal µ-monovision approach performed in surface ablation method: one year results

Session Details

Session Title: Corneal and Scleral Treatment

Session Date/Time: Wednesday 09/09/2015 | 08:00-09:30

Paper Time: 08:00

Venue: Room 13

First Author: : E.Eskina RUSSIA

Co Author(s): :    P. Rybakov   V. Parshina                 

Abstract Details

Purpose:

To investigate the refractive and functional outcomes among two groups of presbyopic patients, myopes and hyperopes, who underwent µ-monovision bi-aspheric multifocal PRK treatments.

Setting:

Prof. Erika N. Eskina, MD, Laser surgery clinic SPHERE, Moscow, Russia.

Methods:

Ongoing clinical study performed on 22 consecutive presbyopic patients (44 eyes), 10 myopic and 12 hyperopic patients in age from 40 to 59 with SEQ from -6.50D to +4.25D and astigmatism up to 2D with surgical add from 1.75D to 2.25D. PresbyMAX µ-Monovision treatments were planned with Custom Ablation Manager software and ablations performed using the SCHWIND AMARIS excimer laser (both SCHWIND eye-tech-solutions). Classic PRK technique and Mitomycin C post laser ablation used in all cases. Uncorrected distance and near visual acuities, refractive outcome, safety, corneal spherical aberration, and contrast sensitivity were recorded up to 12 months of follow up.

Results:

The myopic group (10 patients) showed spherical equivalent power of -0.59±0.55D in distance eyes (DE) and -1.23±0.48D in near eyes (NE). Uncorrected distance visual acuity (UDVA) was 0.08±0.16logMAR. Uncorrected near visual acuity (UNVA) demonstrated +0.07±0.03logRAD. The hyperopic group (12 patients) showed spherical equivalent power of -0.18±0.25D in DE and -0.80±0.56D in NE. UDVA was 0.02±0.08logMAR and UNVA was 0.18±0.13logRAD. In both groups, safety is high with no loss of more than one line (monocular). Preoperative and postoperative corneal spherical aberrations (C(4,0)@6mm) were +0.18±0.06µm and +0.34±0.15µm in myopes respectively +0.23±0.07µm and -0.18±0.22µm in hyperopes. Contrast sensitivity did not significantly change.

Conclusions:

PresbyMAX PRK µ-Monovision highly safe. Refractive outcome and visual acuity stabilizes in the myopic group at 1 to 3 month after surgery, the hyperopic group shows changes still 12 months after surgery. Very good UDVA of 20/20 or better reduces UIVA and UNVA significantly. Change in spherical aberration is more effective in hyperopic presbyopes. Treatments have not affected contrast sensitivity very much. Slight adaption in treatment planning depending on patient's main tasks in distance, intermediate or near vision can improve results and rise individual patient satisfaction. Hyperopes need an even longer follow-up for evaluation of refractive and visual stability.

Financial Interest:

One of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented