Corneal approach to hyperopic presbyopia treatment: six-month outcomes of a new multifocal excimer laser in situ keratomileusis procedure.

PURPOSE

To report the safety and efficacy of treatment of hyperopic presbyopia with a new multifocal corneal laser in situ keratomileusis (LASIK) procedure, Supracor.

SETTING

Mater Private Hospital, Dublin, Ireland.

DESIGN

Case series.

METHODS

Bilateral LASIK using a multifocal corneal ablation profile was performed on consecutive hyperopic presbyopic patients with a manifest refraction spherical equivalent (MRSE) of +1.00 to +3.25 diopters (D) and a maximum 0.75 D difference between the MRSE and cycloplegic refraction. All patients were followed for a minimum of 6 months postoperatively. The main outcome measures were safety, efficacy in terms of uncorrected distance visual acuity (UDVA) and uncorrected reading ability (Vocational Reading Test), predictability, stability, patient satisfaction, and functioning at 6 months.

RESULTS

Forty-six eyes (23 patients) were treated. The mean binocular UDVA was 0.07 logMAR ± 0.12 (SD) at 6 months, with 91% having a binocular UDVA of 0.2 logMAR or better. Ninety-one percent had an uncorrected reading ability of N8 or better, and 93% were fully independent of reading glasses. Six percent lost 2 or more lines of corrected distance visual acuity (CDVA), with 100% maintaining a CDVA of 0.2 logMAR or better. Five patients (22%) required a retreatment in the dominant eye to enhance UDVA. Ninety-six percent were happy they had the procedure.

CONCLUSIONS

The procedure provided a high level of spectacle independence for near vision. The UDVA outcomes must be improved with nomogram adjustment to reduce the retreatment rate. Targeting emmetropia in the dominant eye and 0.50 D myopia in the nondominant eye may be an effective solution.