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Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile
Published on: September 20, 2024
Presbyopia treatment by monocular peripheral presbyLASIK
Robert Leonard Epstein1, Mark Andrew Gurgos
1Mercy Center for Corrective Eye Surgery, McHenry, IL 60050, USA rlepstein@aol.com
Journal of Refractive Surgery (Thorofare, N.J. : 1995)
|July 17, 2009
Summary
Monocular peripheral presbyLASIK combined with distance LASIK offers spectacle independence for presbyopia patients. This refractive surgery approach provides good uncorrected vision at multiple distances.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Corneal Surgery
Background:
- Presbyopia, the age-related loss of near focusing ability, affects a significant portion of the adult population.
- Traditional treatments for presbyopia include reading glasses, bifocals, and multifocal contact lenses.
- Refractive surgery offers a potential alternative for correcting presbyopia, aiming for spectacle independence.
Purpose of the Study:
- To evaluate the efficacy and outcomes of monocular peripheral presbyLASIK (presbyopic LASIK) on the non-dominant eye.
- To assess the combination of peripheral presbyLASIK with distance-directed monofocal refractive surgery on the dominant eye.
- To determine the suitability of this combined approach for treating presbyopia.
Main Methods:
- A cohort of 103 patients underwent a combined surgical procedure using the VISX S4 system.
- Non-dominant eyes were treated with peripheral presbyLASIK, inducing central corneal flattening and peripheral steepening.
- Dominant eyes received distance-focused monofocal LASIK, wavefront-guided LASIK, limbal relaxing incisions, or no treatment.
Main Results:
- High rates of spectacle independence were reported: 91.3% overall, 89% in hyperopes, and 92% in myopes.
- Good uncorrected visual acuity was achieved at distance (≥20/20 in 67.9% of hyperopes, 70.7% of myopes) and near (≥20/20 at 40cm in 71.4% of hyperopes, 65.3% of myopes).
- Peripheral presbyLASIK increased higher-order aberrations, particularly in hyperopic cases, and showed refractive stability in myopes but a slight hyperopic shift in hyperopes over time.
Conclusions:
- Monocular peripheral presbyLASIK, when combined with distance-corrected dominant eye surgery, is a viable treatment option for presbyopia.
- The procedure effectively achieves spectacle independence and functional uncorrected vision across various distances.
- This refractive surgery strategy offers a valuable solution for presbyopic patients seeking improved vision without corrective lenses.
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