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Presbyopic LASIK best for young patients with accommodation
SAN FRANCISCO — Despite a few visual downsides, presbyopic LASIK is an alternative to multifocal IOLs and corneal inlays, particularly in relatively young presbyopes with some accommodation, a speaker said here.
During Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting, Gustavo Tamayo, MD, discussed the multifocality that is generated with presbyopic LASIK.
Gustavo Tamayo
"There are very few options today to treat presbyopia surgically," Tamayo said. "Particularly the intraocular lenses, both multifocal and accommodative lenses, don’t have great acceptance in the general community. The surgical procedures like [conductive keratoplasty], we really don’t know if they have a place or not."
PresbyLASIK creates a multifocal cornea, Tamayo said.
"We know that the combination of a positive spherical aberration with a negative spherical aberration, regardless of the position, is what creates an increase in the depth of focus and improves the near vision," Tamayo said.
Similar to multifocal IOLs, multifocal ablation can result in reduced contrast sensitivity, visual symptoms, especially at night, glare and halos, he said. However, unlike a multifocal IOL, multifocality created with the CustomVue presbyLASIK treatment (Abbott Medical Optics) is reversible, he said.
PresbyLASIK has been shown to afford spectacle independence in up to 92.6% of patients, Tamayo said. In addition, he noted that the procedure is less invasive than implantation of IOLs or inlays.
PresbyLASIK is optimal for patients younger than 55 years of age who have some accommodation, Tamayo said.
Disclosure: Tamayo is an advisor for Abbott Medical Optics, Avedro, Eyegenics, KeraMed and Presbia.