Intrastromal femtosecond laser surgical compensation of presbyopia with six intrastromal ring cuts: 3-year results

Br J Ophthalmol. 2015 Feb;99(2):170-6. doi: 10.1136/bjophthalmol-2014-305642. Epub 2014 Sep 2.


Background/aims: To assess over a 36-month period functional results of the modified INTRACOR femtosecond laser-based intrastromal procedure to treat presbyopia.

Methods: 20 eyes of 20 presbyopic patients with mild hyperopia were included. The INTRACOR procedure with a modified pattern (six concentric intrastromal ring cuts) was performed using the FEMTEC femtosecond laser (Bausch+Lomb/Technolas Perfect Vision, Munich, Germany). Patients were also randomly divided into three subgroups to compare the effect of three different small inner ring diameters (1.8/2.0/2.2 mm (Groups A/B/C)). Follow-up examinations were performed at 1, 3, 6, 12, 24 and 36 months, and included near and distance visual acuity tests, slit-lamp examinations and corneal topography.

Results: Median uncorrected near visual acuity (UNVA) increased from 0.7/0.7/0.7 logMAR (Groups A/B/C) to -0.1/0.1/0.1 logMAR 36 months after surgery. Uncorrected distance visual acuity changed slightly from 0.1/0.2/0.1 logMAR to 0.2/0.3/0.1 logMAR. Losses of two lines of binocular corrected distance visual acuity (CDVA) were noted in 0/25/0% of eyes. Median spherical equivalent changed from 0.75/0.75/0.75 dioptres to -0.19/0.13/-0.19 dioptres. Overall patient satisfaction with the procedure was 80%.

Conclusions: INTRACOR with a modified pattern improved UNVA in all patients over a 36-month follow-up period. The possibility of reduced CDVA underlines the need for careful patient selection.

Trial registration number: NCT00928122.

Keywords: Cornea; Treatment Lasers; Treatment Surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Corneal Stroma / surgery*
  • Corneal Surgery, Laser / methods*
  • Corneal Topography
  • Female
  • Follow-Up Studies
  • Humans
  • Lasers, Excimer / therapeutic use*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Presbyopia / physiopathology
  • Presbyopia / surgery*
  • Prognosis
  • Prospective Studies
  • Refraction, Ocular / physiology*
  • Surveys and Questionnaires
  • Visual Acuity / physiology*

Associated data