Purpose: To investigate central multifocal presbyLASIK based on the creation of a central hyperpositive area.
Methods: Twenty-five patients (50 eyes) underwent presbyLASlK in an open-label, prospective, non-comparative pilot study. Mean patient age was 58 years (range: 51 to 68 years), mean preoperative spherical equivalent refraction was +1.6 +/- 0.63 diopters (D) (range: +0.50 to +3.00 D), and mean spectacle near addition was +2.27 +/- 0.37 D (range: +1.75 to +3.00 D). The ablation pattern was performed with proprietary software from Technovision using an H. Eye Tech. excimer laser platform.
Results: Mean postoperative spherical equivalent refraction was -0.37 +/- 0.55 D (range: -1.50 to + 1.00 D) and mean spectacle near addition was +1.72 +/- 0.34 D (range: +1.25 to +2.25 D). After 6 months, 16 (64%) patients achieved a distance uncorrected visual acuity (UCVA) of > or = 20/20 and 18 (72%) patients achieved a near UCVA of > or = 20/40. Seven (28%) patients lost a maximum of 2 lines of best spectacle-corrected visual acuity (BSCVA). The safety index for distance was 0.98 binocular and for near was 0.99 binocular. After 6 months, no significant change was noted in contrast sensitivity at 1.5 cycles/degree. A significant mean reduction was found at spatial frequencies of 3, 6, 12, and 18 cycles/degree (P<.001). There was a significant change in corneal aberrations after surgery. The coefficients for coma increased and the coefficients for spherical aberrations decreased. A significant decrease was noted in point spread function values (P=.0018).
Conclusions: Central presbyLASIK may be used to provide improvement in functional near vision in patients with presbyopia associated with low and moderate hyperopia. However, factors involved in the loss of BSCVA in some cases and loss in vision quality should be further clarified prior to its general use.