Functional Outcomes and Reading Speeds following PRESBYOND LBV Using Nonlinear Aspheric Ablation Profiles Combined with Micro-Monovision

Abstract

Purpose. To report the functional outcomes and reading speeds following PRESBYOND laser blended vision (LBV) using nonlinear aspheric ablation profiles with micro-monovision with the Carl Zeiss Meditec MEL 90 platform. Methods. Data have been collected retrospectively for all patients who underwent PRESBYOND LBV using the MEL 90 excimer laser. Postoperative binocular uncorrected distance and near visual acuity, stereo-acuity, contrast sensitivity, and reading performance were compared with pre-op values measured with patient’s progressive glasses. Mean follow-up was 6 ± 1.2 months. Results. Sixty eyes of 30 patients (mean age 50.47 ± 6.43 years) were included. Of these, 18 patients were hyperopic and 12 patients were myopic with mean SE of 1.28 ± 1.38 D and −2.84 ± 1.86 D, respectively. At 6 months, the mean binocular UDVA was ≥−0.03 ± 0.06 log MAR and the mean binocular UNVA was ≥0.22 ± 0.04 log MAR. The uncorrected reading speeds (words per minute) at the preferred reading distance of 46.17 cm, 60 cm, and 80 cm were significantly better ( p value <0.01), whereas the smallest letter size and reading acuities were comparable to the preoperative values ( p > 0.05 for all distances). Uncorrected contrast sensitivity log values showed mild reduction; however, this was not statistically significant for any spatial frequency. There was a significant reduction in post uncorrected stereopsis to 89.67 arc sec, compared with pre-op corrected stereopsis (50.67 arc sec); however, it recovered fully with near correction (53.33 arc sec, p > 0.05 compared with pre). Conclusion. PRESBYOND LBV resulted in significantly better reading speeds and satisfactory functional visual outcomes, without a permanent change in stereo-acuity and contrast sensitivity 6 months postoperatively.

Outcomes of Corneal Compound Myopic Astigmatism with Presbyopia by Zeiss PRESBYOND® Laser Blended Vision LASIK Using Default CRS-Master® Target Refractions for Reduced Anisometropia

“…Induced micro-anisometropia is better tolerated by the patient thanks to the induction of spherical aberration, which, by generating an increase in depth of focus, leads to satisfactory visual outcomes in intermediate vision [24][25][26]. To our knowledge, all published studies on PRESBYOND ® have shown results after surgery with micro-anisometropia and a myopic target of −1.50, regardless of age [10,[13][14][15][27][28][29].…”

Exploring the Effect of Preoperative Stereopsis on Visual Outcomes in Hyperopic Presbyopes Treated with PresbyOND® Laser Blended Vision Micro-Monovision

“…The study emphasized the safety and effectiveness of the treatment for a wide range of presbyopia conditions. Brar et al 2021 [15] reported functional outcomes like reading speeds 6 months after operation. The study found that PRESBYOND LBV resulted in better reading speeds and overall satisfactory functional visual outcomes.…”

“…Their pilot study suggests that the phenomenological experience of 'realness' in stereopsis could be dissociable from depth perception based on binocular disparity. Preliminary data suggests that a keen focus on maintaining or even enhancing stereopsis could significantly elevate the efficacy of Laser Blended Vision [11][12][13]15]. In line with this, Cheng et al [18] found that normal observers were able to judge equidistance with high accuracy and precision using static and dynamic monocular depth information, suggesting that monocular vision may also be effective for distance-dependent tasks in natural environments.…”

“…However, even these advanced options had limitations, including a decrease in contrast sensitivity and stereopsis. The introduction of PresbyOND ® Laser Blended Vision was thus a watershed moment that involved the ingenious use of micro-monovision techniques combined with induced spherical aberration to improve depth of focus [4,[11][12][13][14][15].…”

Choosing the right surgical treatment for hyperopia

“…For those with latent hyperopia (most young adults fall into this category) preoperative adaptation to a higher prescrip-tion (possibly as close to cyclorefraction as possible) should therefore be considered [14]. Hyperopic presbyopes can still be treated with FS-LASIK or LASIK providing the degree of hyperopia is low enough to accommodate the extra treatment required for a laser blended vision treatment (micromonovision) to make them spectacle independent [15,16]. Additional consideration should be given to the anticipated postoperative K reading.…”