CK for presbyopia complements previous refractive procedures

Post-LASIK and post-PRK patients who underwent CK for presbyopia gained good near vision without losing distance, pilot study finds.

ByJared Schultz

LISBON — Conductive keratoplasty can improve near vision in presbyopic patients who have undergone previous refractive surgical treatments, according to one surgeon.

Daniel S. Durrie

Ocular Surgery News U.S. Edition Refractive Surgery Section Editor Daniel S. Durrie, MD, presented preliminary pilot study data on 27 patients who underwent NearVision CK for presbyopia after LASIK or PRK. The procedure was performed using the ViewPoint device from Refractec.

The mean patient age was 53. The mean uncorrected vision before the CK enhancement at near was 20/100, and distance was 20/40.

Patients were treated in one eye with eight spots in a 7.5-mm optical zone, which Dr. Durrie explained was a conservative treatment amount.

“One of the goals we are trying to do is to be conservative enough to get the near vision improvement without losing distance vision,” he told attendees at the European Society of Cataract and Refractive Surgeons meeting in Lisbon.

Results encouraging

Follow-up visits at 1 day and 1 and 3 months included measurements of near and distance acuity, and wavefront analysis.

At the 3-month follow-up point, the mean near UCVA was 20/39, with 70.4% seeing 20/40 or better. The mean uncorrected distance UCVA was 20/41, which was a minimal change from preop measurements, Dr. Durrie said. The mean sphere was –0.75 D, and the mean cylinder was –0.51 D.

Dr. Durrie and his colleagues gave the patients a questionnaire to determine the effects of the procedure on their day-to-day activities such as reading a letter, a menu or a golf score.

“There was a significant improvement, and especially when they looked at small print such as a medicine bottle or legal forms, we had a large improvement in functional near vision,” he said.

He added that 52% of the patients wore glasses for reading preoperatively, and this fell to 10% after CK.

“There is high patient satisfaction with functional vision and little or no compromise in uncorrected binocular distance acuity,” he said.

Dr. Durrie, an associate clinical professor of ophthalmology at the Kansas University Medical Center, explained that CK is particularly successful in patients who are close to plano, including patients who were brought to plano either through LASIK or with IOLs.

“People are either born that way or we make them that way with our IOLs or with LASIK,” he said.

With this in mind, he said that future studies are planned to further explore the correction of accommodative problems that develop after previous corrective procedures.

For Your Information:

Daniel S. Durrie, MD, can be reached at Durrie Vision, 5520 College Blvd., Suite 201, Overland Park, KS 66211 U.S.A.; +1-913-491-3330; e-mail: ddurrie@durrievision.com. Dr. Durrie is a paid consultant for and performs research funded by Refractec.

Refractec, maker of the ViewPoint conductive keratoplasty system, can be reached at 5 Jenner, Suite 150, Irvine, CA 92618 U.S.A.; Web site: www.refractec.com.

Jared Schultz is an OSN Staff Writer who covers all aspects of ophthalmology. He focuses geographically on Europe and the Asia-Pacific region.