First Author: I.Novak RUSSIA
Co Author(s): S. Anisimov S. Semyonov V. Sivtseva
Purpose:
During many years LASIK proved itself as a safe, efficient and predictable method in correction of different kinds of ametropia. New LASIK algorithms - wavefront guided and wavefront optimized lead to the main goal of refractive surgery when uncorrected optical and visual characteristics after operation would be better than the same parameters with sphere or (and) cylinder correction before the surgery. Thus, in complicated cases (after previous refractive surgery, keratoplastic, in cases of thin corneas or ambliopia) patients could be satisfied with surgery results. So one can say that the number of indications for LASIK procedures increased during last period. But there still was no efficient algorithm of laser correction in cases of presbyopia. On the one hand the number of presbyopic patients steadily increases and is expected to be 1.4 bln in 2020. On the other hand, the fast development of information technologies results in increasing of near and intermediate vision activity and the time spent near computers and different mobile devices. That's why it is important to find solutions for presbyopia correction.
Supracor seems to be a new promising algorithm of presbyopia laser correction. The purpose or our work was to evaluate its efficiency and predictability.
Setting:
Eye Center " East Sight recovery"
Methods:
32 Supracor procedures were performed in patients aged from 50 to 58 years with combination of hyperopia and presbyopia.
The inclusion criteria were as follows: +1.0D to +4,0D MRSE, up to 1.5 D astigmatism; mean K-readings were up 44.0D; age 50 years and more; near addition of +2.0D needed; maximal 0.5D difference between cyclo and manifest refraction SE; both eyes with corrected vision 0.8 and more; no previous eye surgery, clear medias; common LASIK restrictions. All procedures were performed bilateral.
In all cases besides standart ophthalmology examination corneal topography and aberrometry on Zyoptix working station (ORBSCAN® IIz Anterior Segment Analysis System Version 2.3 and Zywav? II Aberrometer) were performed. Surgical treatment was performed on excimer laser Technolas 217z 100 in Supracor algorithm. All surgery stages were the same as in standard LASIK. But while other laser presbyopic algorithms create undesired aberrations inside the pupil region, Supracor provides the near addition without inducing undesired aberrations.
All patients received antibiotics topically during 5 days and cornea protector drops during 2-3 weeks.
The observation period was 1 year.
Results:
Monocular, binocular distance and near vision acuity (VA), refractometry and aberrometry were performed before and after the surgery (next day, 1 week, 3 and 6 months).
The main parameters to evaluate were the patient ability to refuse from distance and reading glasses and the level of higher order aberrations (HOA). Next day after the operation the HOA shift was noted almost in all cases and it could be explained by partial adhesion of the flap to stromal bed in first hours after operation. From 1 to 3 monts after the surgery HOA decreased.
The day after the surgery monocular uncorrected distance VA was 0.8-1.0 and binocular 1.0, and the patients had no need in distance glasses. Monocular uncorrected near VA was 0.5-0.8, binocular 0.6-0.9.
1 month after the surgery monocular uncorrected distance VA was 0.6-1.0 and binocular 0.8-1.0 . Monocular uncorrected near VA was 0.4-0.7, binocular 0.5-0.8. These results left stable during all observation period.
In 9 % of all cases patients used reading glasses but only in low light conditions.
All patients were satisfied with the results of the surgery.
Conclusions:
Supracor is safe and predictable procedure in cases of presbyopia combined with hyperopia. But more studies are necessary to evaluate the efficiency of this method in cases of presbyopia combined with other kinds of ametropia. FINANCIAL DISCLOSURE?: No
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