Journal of Refractive Surgery

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Original Article 

Correction of Presbyopia in Hyperopia With a Center-distance, Paracentral-near Technique Using the Technolas 217z Platform

Dolores Ortiz, PhD; Roberto Pinelli, MD; Anna Simonetto, MA; Esperanza Sala, OD; Cristian Bacchi, OD; Jorge L Alió, MD, PhD

Abstract

PURPOSE

To analyze the results of hyperopic patients treated with a peripheral presbyLASIK algorithm for the correction of presbyopia.

METHODS

The study included 44 eyes of 22 hyperopic patients treated with a peripheral presbyLASIK technique using a Technolas 217z excimer laser. Mean patient age was 56 years (range: 47 to 72 years), mean preoperative spherical equivalent refraction was +1.21±0.77 diopters (D) (range: +0.50 to +4.00 D), and mean spectacle near addition was 1.76±0.42 D (range: +1.00 to +2.75 D). The Peripheral Multifocal LASIK (PML) ablation pattern creates a multifocal corneal profile over a 6.5-mm diameter, performing the distance correction first in a 6-mm optical zone and then near correction in a 6.5-mm zone. Main outcome measures were uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) for near and distance, spherical equivalent refraction, contrast sensitivity, and corneal aberrations.

RESULTS

Six months postoperatively, mean binocular UCVA was 1.06±0.13 for distance and 0.84±0.14 for near. Mean postoperative spherical equivalent refraction was –0.42 D (range: –1.12 to +0.87 D). Two (4.5%) eyes lost 1 line of BSCVA for distance and near vision, and 20 (45%) eyes gained 1 line of distance BSCVA. Contrast sensitivity decreased for 3, 6, 12, and 18 cycles/degree. Corneal aberration analysis showed a slight increase in coma and decrease in spherical aberration.

CONCLUSIONS

The peripheral presbyLASIK technique used in this study is a safe and efficient treatment that may improve functional near vision in presbyopic patients with low and moderate hyperopia (from +0.50 to +3.00 D). [J Refract Surg. 2008;24:494-500.]

ABOUT THE AUTHORS

From the Istituto Laser Microchirurgia Oculare, Brescia, Italy (Pinelli, Simonetto, Bacchi); the Research and Development Department, Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain (Ortiz, Sala, Alió); and the Ophthalmology Department, Miguel Hernández University, Alicante, Spain (Alió).

This study was supported in part by a grant of the Spanish Ministry of Health, Instituto Carlos III, Red Temática de Investigación en Oftalmologia, Subproyecto de Cirugia Refractiva y Calidad Visual (C03/13) and by a grant from the Spanish Generalitat Valenciana, ref: Grupos05/036 Grants and Support for scientific research and technological development in the Comunidad Valenciana for the year 2005.

Dr Pinelli has a proprietary interest in the PML software. The remaining authors have no proprietary interest in the materials presented herein. Correspondence: Jorge L. Alió, MD, PhD, Research and Investigation Department, Instituto Oftalmológico Alicante, Vissum Corporation, Avda Denia s/n, Edificio Vissum, 03016 Alicante, Spain. Tel: 34 902 333 344; Fax: 34 965 160 468; E-mail: jlalio@vissum.com

Received: September 13, 2006

Accepted: March 16, 2007

Posted online: October 31, 2007

Abstract

PURPOSE

To analyze the results of hyperopic patients treated with a peripheral presbyLASIK algorithm for the correction of presbyopia.

METHODS

The study included 44 eyes of 22 hyperopic patients treated with a peripheral presbyLASIK technique using a Technolas 217z excimer laser. Mean patient age was 56 years (range: 47 to 72 years), mean preoperative spherical equivalent refraction was +1.21±0.77 diopters (D) (range: +0.50 to +4.00 D), and mean spectacle near addition was 1.76±0.42 D (range: +1.00 to +2.75 D). The Peripheral Multifocal LASIK (PML) ablation pattern creates a multifocal corneal profile over a 6.5-mm diameter, performing the distance correction first in a 6-mm optical zone and then near correction in a 6.5-mm zone. Main outcome measures were uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) for near and distance, spherical equivalent refraction, contrast sensitivity, and corneal aberrations.

RESULTS

Six months postoperatively, mean binocular UCVA was 1.06±0.13 for distance and 0.84±0.14 for near. Mean postoperative spherical equivalent refraction was –0.42 D (range: –1.12 to +0.87 D). Two (4.5%) eyes lost 1 line of BSCVA for distance and near vision, and 20 (45%) eyes gained 1 line of distance BSCVA. Contrast sensitivity decreased for 3, 6, 12, and 18 cycles/degree. Corneal aberration analysis showed a slight increase in coma and decrease in spherical aberration.

CONCLUSIONS

The peripheral presbyLASIK technique used in this study is a safe and efficient treatment that may improve functional near vision in presbyopic patients with low and moderate hyperopia (from +0.50 to +3.00 D). [J Refract Surg. 2008;24:494-500.]

ABOUT THE AUTHORS

From the Istituto Laser Microchirurgia Oculare, Brescia, Italy (Pinelli, Simonetto, Bacchi); the Research and Development Department, Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain (Ortiz, Sala, Alió); and the Ophthalmology Department, Miguel Hernández University, Alicante, Spain (Alió).

This study was supported in part by a grant of the Spanish Ministry of Health, Instituto Carlos III, Red Temática de Investigación en Oftalmologia, Subproyecto de Cirugia Refractiva y Calidad Visual (C03/13) and by a grant from the Spanish Generalitat Valenciana, ref: Grupos05/036 Grants and Support for scientific research and technological development in the Comunidad Valenciana for the year 2005.

Dr Pinelli has a proprietary interest in the PML software. The remaining authors have no proprietary interest in the materials presented herein. Correspondence: Jorge L. Alió, MD, PhD, Research and Investigation Department, Instituto Oftalmológico Alicante, Vissum Corporation, Avda Denia s/n, Edificio Vissum, 03016 Alicante, Spain. Tel: 34 902 333 344; Fax: 34 965 160 468; E-mail: jlalio@vissum.com

Received: September 13, 2006

Accepted: March 16, 2007

Posted online: October 31, 2007

10.3928/1081597X-20080501-07

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