PresbyLASIK treatment for simultaneous correction of presbyopia and ametropia: development to PresbyMax hybrid at the Augenklinik Bellevue

Session Details

Session Title: Hyperopic corrections

Session Date/Time: Sunday 14/09/2014 | 16:30-18:00

Paper Time: 17:24

Venue: Boulevard B

First Author: : D.Holland GERMANY

Co Author(s): :    M. Poelzl   D. Hepper   D. Uthoff        

Abstract Details

Purpose:

The treatment of Presbyopia is still one of the greatest challenges in ophthalmology. Apart from MIOL implantation which in the moment is the most widely used surgical therapy other treatment options like intracorneal inlays and scleral expanding systems are alternative treatment options. But all this methods have their limitations. In MIOL implantation there is still the risk of an intraocular surgery, e.g. endophthalmitis. Besides this not all patients are willing to undergo intraocular surgery if other options are available. One of these options is monovision or Presbylasik with the excimer laser. We investigated the long-term outcomes for simultaneous correction of presbyopia and ametropia by biaspherical Presby-Lasik technique based on the creation of a central area hyperpositive for near vision and leaving the midperipheral cornea for far vision with a concept called PresbyMax on the Schwind Amaris plattform. The technique was modified by transition to a monovision concept (PresbyMAX hybrid) and improves safety and efficiency.

Setting:

Augenklinik Bellevue in Kiel/Germany

Methods:

86 presbyopic patients were treated with a FEMTO-LASIK and were assessed 3 years postoperatively. In the following the sub-sample of 24 hybrid patients should be considered. Mean patient age was 52.0 ± 7.71 years. The preoperative sphere ranged from -8.25 to +5.25 dpt. and the astigmatism from 0.0 to 4.0 dpt. The dominant eye was treated with up to 1.0 dpt. less addition then the non-dominant eye for the central near vision area and the non-dominant eye had increased myopic target refraction in the peripheral distance zone.

Results:

Mean DUCVA improved from 0.55 (preoperative) to 0.11 logMar (6 months postoperatively). DUCVA binocular improved from 0.51 logMar to 0.00 logMar (6 months postop). Mean NBCVA changed from 0.0 logRAD preoperative to 0.07 logRAD postoperative. NUCVA improved from 0.49 logRAD to 0.19 logRAD. Mean postoperative sphere in the myopic group was -0.32 dpt and mean cylinder was 0.38 dpt. In the hyperopic group the mean postoperative sphere was -0.29 dpt and the mean cylinder 0.40 dpt.

Conclusions:

In presbyopic patients without symptomatic cataract, but refractive errors PresbyMAX will decrease the presbyopic symptoms and correct far-distance refraction in the same treatment offering spectacle-free vision in daily life in most of the treated patients

Financial Interest:

NONE