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Wavefront-guided multifocal ablation for hyperopic presbyopia improves near vision
J Refract Surg. 2008;24(9):903-910.
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Wavefront-guided multifocal corneal ablation offered good results in treating hyperopic presbyopia, with insignificant higher-order aberrations and decreases in contrast sensitivity 6 months after surgery.
The retrospective study included 54 eyes of 27 patients with a mean age of 52.7 years (range, 45 to 63 years). All patients underwent refractive surgery with the VISX CustomVue System (Advanced Medical Optics). PRK was performed on seven eyes, LASIK on 25 eyes and epi-LASIK on 22 eyes.
Near visual acuity was assessed at 40 cm, and distance visual acuity was tested at 5 m.
Before surgery, 39 of 54 eyes (72%) had monocular distance uncorrected visual acuity of 0.5 Snellen equivalent or better. At 1 month, 42 eyes of 48 eyes (88%) saw 0.5 or better, and at 6 months, 28 of 28 eyes (100%) of eyes saw 0.5 or better.
Monocular near UCVA was 0.65 or worse in all 54 eyes before surgery. At 1 month after surgery, 29 of 48 eyes (60%) had monocular near UCVA of 0.65 or better. At 6 months, 11 of 28 eyes (39%) had monocular near UCVA of 0.65 or better.
Twenty-four eyes that underwent PRK or epi-LASIK had better binocular near UCVA than 18 eyes that had LASIK.
The multifocal wavefront customized corneal ablations with a central near zone in hyperopic presbyopia can provide effective correction. According to the study, the surface ablation (PRK/epi-LASIK) gave better uncorrected binocular near vision results as compared to LASIK. The clinical application of the study is that it showed how the patient satisfaction can be improved by providing significant change in near vision without significant increase in corneal total higher-order aberration or significant decrease in contrast sensitivity.
– Amar Agarwal, MS, FRCS, FRCOphth
OSN India Edition Editorial Board Member