One-Year Experience in Presbyopia Correction With Biaspheric Multifocal Central Presbyopia Laser In Situ Keratomileusis

Abstract

Patient selection and expectation management is essential to achieve patient satisfaction. Even though optically the results are predictable and good, some patients find it difficult to adapt to the compromise and others are dissatisfied by the minor loss of distance visual acuity. Certain individuals are best suited for PresbyMAX. A test with multifocal contact lenses or trial frames that creates slightly defocused images can be used to simulate postoperative visual impressions and verify patient acceptance.

Surgical compensation of presbyopia with corneal inlays

“…Corneal laser presbyopic correction can also have similar side effects, such as loss of distance visual acuity, haloes and glare [12][13][14]. In addition, the laser-induced corneal changes tend to be irreversible.…”

Presbyopic LASIK Using Hybrid Bi-Aspheric Micro-Monovision Ablation Profile for Presbyopic Corneal Treatments

“…The hybrid surgical technique involved treating the dominant eye (also referred to as the distant eye) more towards distance vision (target refraction -0.1D) and the non-dominant eye (also referred to as the near eye) slightly towards near vision (target refraction -0.9 D) for achieving micromonovision. Multifocality 20,21,22,11 increases the range of intermediate vision with a different depth of focus between the distant eye (+1.1D) and the near eye (+2.2D).…”

“…PresbyLASIK has been stated as a promising technology, but lacking the level of maturity of monovision 11 . For achieving maximum patient satisfaction, good near vision should be accompanied with no detrimental effect in the distance vision.…”

PresbyLASIK approach for the correction of presbyopia

“…However, most papers report a relatively high patient satisfaction and a high degree of spectacle independence [8,9,14]. Although spectacle independence and patient satisfaction does not necessarily correlate closely with binocular combined near/far visual acuity, the reason may be patient tolerance.…”

“…Luger et al [7,8] studied the concurrent vision (distance and near) after bi-aspheric multifocal central presbyLASIK procedure (PresbyMAX) for hyperopia and myopia with or without astigmatism, at 3 months [7] and 12 months [8] follow up. At 3 months postoperatively, 71% of patients achieved UDVA 0.1 logMAR or better (70% at 1 year), 79% patients obtained UNVA 0.1 logRAD or better (84% at 1 year), and 83% of eyes were within 0.75 D of defocus (same at 1 year).…”