Multifocal Femto-PresbyLASIK in Pseudophakic Eyes

Background: Presbyopia treatment in pseudophakic patients with a monofocal IOL is challenging. This study investigates the refractive results of femto-PresbyLASIK and analyzes presbyopia treatment in pseudophakic eyes. Methods: 14 patients with 28 pseudophakic eyes were treated with femto-PresbyLASIK. The dominant eye was targeted at a distance and the non-dominant eye at −0.5 D. The presbyopic algorithm creates a steepness in the cornea center by using an excimer laser that leads to corneal multifocality. Results: 6 months after surgery a refraction of −0.11 ± 0.13 D (p = 0.001), an uncorrected distance visual acuity of 0.05 ± 1.0 logMAR (p < 0.001) and an uncorrected near visual acuity of 0.15 ± 0.89 logMAR (p = 0.001) were achieved in the dominant eye. For the non-dominant eye, the refraction was −0.28 ± 0.22 D (p = 0.002), the uncorrected distance of visual acuity was 0.1 ± 1.49 logMAR, and the uncorrected near visual acuity was 0.11 ± 0.80 logMAR (p < 0.001). Spherical aberrations (Z400) were reduced by 0.21–0.3 µm in 32% of eyes, and by 0.31–0.4 µm in 26% of eyes. Conclusion: By steepening the central cornea while maintaining spherical aberrations within acceptable limits, PresbyLASIK created a corneal multifocality that safely improved near vision in both eyes. Thus, femto-PresbyLASIK can be used to treat presbyopia in pseudophakic eyes without performing intraocular surgery.

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One Year Outcome and Satisfaction of Presbyopia Correction Using the PresbyMAX® Monocular Ablation Profile

Frontiers in Medicine ◽

10.3389/fmed.2020.589275 ◽

2020 ◽

Vol 7 ◽

Author(s):

Dan Fu ◽

Jing Zhao ◽

Li Zeng ◽

Xingtao Zhou

Keyword(s):

Visual Acuity ◽

Final Visit ◽

Great Satisfaction ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Dominant Eye ◽

Ablation Profile ◽

Near Visual Acuity ◽

One Year

Purpose: To explore the safety, efficacy, and satisfaction of the PresbyMAX monocular mode for the correction of presbyopia.Methods: Prospective study. Twenty-two patients (mean age 50.6 ± 6.2 years, 11 myopia patients and 11 hyperopia patients) were enrolled. The dominant eye was fully corrected for distance vision; the non-dominant eye was corrected using central PresbyMAX monocular mode. Binocular uncorrected distance visual acuity (BUDVA), near visual acuity (BUNVA), intermediate visual acuity (BUIVA), corrected distance visual acuity (CDVA), and mean spherical equivalent (SE) were tested at 1 day, 1 week, 1 month, 3 months, and 1 year postoperatively. Questionnaire was performed preoperatively, 1 month, 3 months, and 1 year after surgery.Results: At the final visit, the mean safety index was 1.03 ± 0.14. There were 85.7% eyes with the same or better CDVA than the preoperative value, and 17.1% and 2.9% eyes gained 1 line and 2 lines of CDVA, respectively. All treated eyes achieved 20/25 or better BUDVA, and 95.5% achieved 20/32 or better BUNVA, which improved significantly compared with preoperative values (P < 0.001). BUDVA maintained stability from 1 month postoperatively, BUNVA and BUIVA kept stable since 1 week after surgery. Overall satisfaction was 95.5% (21/22) at 3 months visit, and 100% at the last visit. No differences in terms of visual acuity and satisfaction were found between the myopia and hyperopia groups.Conclusion: The PresbyMAX monocular ablation profile was safe and effective in treating presbyopia, with great satisfaction achieved at postoperative 1 year.

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Evaluation of Different Power of Near Addition in Two Different Multifocal Intraocular Lenses

Journal of Ophthalmology ◽

10.1155/2016/1395302 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Ugur Unsal ◽

Gonen Baser

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Intraocular Lenses ◽

Near Vision ◽

Distance Visual Acuity ◽

Multifocal Intraocular Lenses ◽

Uncorrected Distance Visual Acuity ◽

Quality Of Vision ◽

Corrected Distance Visual Acuity ◽

Near Visual Acuity

Purpose.To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted.Methods.41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later.Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50andp=0.509, resp.). The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049,p=0.005, andp=0.001, resp.) and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001). The patient satisfactions of both groups were similar.Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities), whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading).

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Optimal Keratoplasty for the Correction of Presbyopia and Hypermetropia

Journal of Ophthalmology ◽

10.1155/2017/7545687 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6

Author(s):

Daniele Veritti ◽

Valentina Sarao ◽

Paolo Lanzetta

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Postoperative Complications ◽

Safety And Efficacy ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Ophthalmologic Examination ◽

Near Visual Acuity ◽

Better Than

Purpose.To evaluate prospectively the safety and efficacy of optimal keratoplasty for the correction of hyperopia and presbyopia.Methods. Consecutive patients undergoing bilateral optimal keratoplasty for refractive presbyopic and hypermetropic corrections were enrolled. Each patient received a complete ophthalmologic examination at baseline, 1 hour, 1 day, 1 week, 1 month, 3 months, and 6 months after treatment.Results. The study included 40 consecutive eyes of 20 patients. All patients reached the 6-month follow-up. No serious intra- or postoperative complications were recorded. Monocular and binocular uncorrected near visual acuities improved significantly during the follow-up (p<0.001). Binocular uncorrected distance visual acuity in presbyopic patients improved from 0.28 logMAR to a maximum of 0.04 logMAR (from 20/38 to 20/22 Snellen equivalent) the day after the treatment and remained significantly better than baseline until the end of the follow-up. A significant improvement of patient satisfaction for near (p<0.001) and distance (p=0.007) activities was seen the day after treatment and was maintained throughout the follow-up.Conclusions.Optimal keratoplasty is a safe, noninvasive, rapid, pain-free, office-based procedure. It offers low to moderate hyperopes and presbyopes an improvement in uncorrected near visual acuity while maintaining or improving their distance visual acuity.

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Comparison of the Clinical Performance of Refractive Rotationally Asymmetric Multifocal IOLs with Other Types of IOLs: A Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2018/4728258 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13

Author(s):

Zequan Xu ◽

Wenzhe Li ◽

Lianqun Wu ◽

Shuang Xue ◽

Xu Chen ◽

...

Keyword(s):

Visual Acuity ◽

Clinical Performance ◽

Meta Analysis ◽

Higher Order ◽

Controlled Trials ◽

Strehl Ratio ◽

Higher Order Aberrations ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Near Visual Acuity

Objective. To compare the clinical performance of refractive rotationally asymmetric multifocal intraocular lens (IOLs) with spherical monofocal, accommodating, and bifocal IOLs. Methods. A comprehensive literature search of PubMed, EMBASE, Cochrane Controlled Trials Register, and Web of Science up to February 2017 was performed to identify randomized controlled trials (RCT) and comparative cohort studies. Main outcomes were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), higher-order aberrations (HOAs), MTF, Strehl ratio, and residual sphere and cylinder. Results. Mplus provided significantly worse UDVA than spherical monofocal IOLs (WMD: 0.13, P=0.008), but significantly better UIVA than high-add bifocal IOLs (WMD: −0.19, P<0.00001), spherical monofocal IOLs (WMD: −0.12, P<0.0001), and accommodating IOLs (WMD: −0.21, P<0.00001). Mplus provided significantly worse UNVA than high-add bifocal IOLs (WMD: 0.07, P<0.00001), but significantly better UNVA than spherical monofocal IOLs (WMD: −0.19, P<0.00001). Mplus resulted in significantly higher HOAs than high-add bifocal IOLs (WMD: 0.38, P<0.00001) and spherical monofocal IOLs (WMD: 0.51, P=0.0004). Mplus provided a significantly lower MTF cut-off and Strehl ratio than other type of IOLs. Conclusion. The Mplus IOLs perform best regarding intermediate visual acuity whereas they lack in distance visual acuity compared to monofocal IOLs and near visual acuity compared to bifocal IOLs. These results may be due to structure of Mplus IOLs resulting in higher-order aberrations.

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3 Years Clinical Outcomes of Aspheric Micro-monovision LASIK for Correction of Presbyopia and Myopic Astigmatism

10.21203/rs.2.15661/v1 ◽

2019 ◽

Author(s):

Fang Liu ◽

Ting Zhang ◽

Quan Liu

Keyword(s):

Visual Acuity ◽

Subjective Rating ◽

Spherical Equivalent ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

High Satisfaction ◽

Manifest Refraction ◽

Corrected Distance Visual Acuity ◽

Near Visual Acuity

Abstract Background: To investigate long term safety and efficacy of aspheric micro-monovision LASIK for correction of presbyopia and myop ic astigmatism. Methods: One hundred and fourteen eyes of 57 patients with a mean age 48 ± 4.05 years (range: 43 to 62 years) undergoing aspheric micro-monovision LASIK treatment using the MEL 80 excimer laser (Carl Zeiss Meditec AG, Jena, Germany) were enrolled. Visual acuity, manifest refraction, amplitude of accommodation and patients’ subjective rating was evaluated from 1 day to 3 years postoperatively. Results: There were no eyes in which spherical equivalent changed by over 0.75D between 1 day and 3 years. Ninety five percent of eyes were within ±0.50 D of target correction of spherical equivalent. The percentage of monocular uncorrected distance visual acuity ≧20/20 was 95%,and all eyes achieved 20/25 or better. The percentage of binocular uncorrected near visual acuity ≧J2 was 93%,and all patients achieved J4 or better. Ninety one percent of the patients could see uncorrected both 20/20 and J2 or better binocularly. Six percent (6/108) eyes lost 1 line and no eyes lost 2 lines of corrected distance visual acuity. The overall satisfaction score for surgery was 93±6. Conclusions: The aspheric micro-monovision LASIK using the Carl Zeiss Meditec MEL 80 Platform was an efficacious option for older myopia patients with presbyopia. Three years postoperative outcomes in Chinese population indicated improvements in uncorrected binocular vision at far and near distances with high satisfaction.

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Small incision lenticule extraction (SMILE) monovision for presbyopia correction

European Journal of Ophthalmology ◽

10.5301/ejo.5001069 ◽

2017 ◽

Vol 28 (3) ◽

pp. 287-293 ◽

Cited By ~ 13

Author(s):

Nikolaus Luft ◽

Jakob Siedlecki ◽

Walter Sekundo ◽

Christian Wertheimer ◽

Thomas C. Kreutzer ◽

...

Keyword(s):

Visual Acuity ◽

Small Incision Lenticule Extraction ◽

Distance Visual Acuity ◽

Small Incision ◽

Uncorrected Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Effective Option ◽

Near Visual Acuity ◽

Lenticule Extraction ◽

Target Refraction

Purpose: To evaluate the outcomes of myopic small incision lenticule extraction (SMILE) monovision in presbyopic patients. Methods: This study included 49 presbyopic patients older than 45 years seeking surgical correction of myopia or myopic astigmatism who underwent bilateral SMILE with planned monovision in the SMILE Eyes Clinic Linz, Austria. Target refraction was plano for dominant (distance) eyes and ranged between -1.25 and -0.50 D for nondominant (near) eyes. Best-corrected distance visual acuity, uncorrected distance visual acuity (UDVA), uncorrected near visual acuity, as well as spectacle dependence were assessed after a mean postoperative period of 7.2 ± 4.8 months. Results: Mean age was 49 ± 3 years and female to male ratio was 30:19. Distance eyes achieved a spherical equivalent correction of ±0.50 D from target refraction in 80% of patients and 96% were within ±1.0 D. Binocular UDVA of 20/20 or better was achieved by 90% of patients and all patients achieved 20/25 or better. The proportion of patients with a binocular UDVA of 20/20 or better who could read J2 or better amounted to 84%. Complete spectacle independence was achieved by 84% of patients and independence from reading glasses was achieved in 92% of cases. No patient requested refractive enhancement or monovision reversal. Conclusions: This first evaluation of SMILE monovision endorses the approach as a safe and effective option for the correction of presbyopia in myopic patients seeking refractive surgery.

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Myopic lasik outcomes: comparison of three different femtosecond lasers and a mechanical microkeratome using the same excimer laser

10.21203/rs.2.9378/v1 ◽

2019 ◽

Author(s):

Juan Gros-Otero ◽

Isabel Rodriguez-Perez ◽

Miguel A. Teus ◽

Andreas Katsanos ◽

Dimitrios G. Mikropoulos ◽

...

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Femtosecond Lasers ◽

Safety Index ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Observational Cohort ◽

Efficacy Index ◽

Retrospective Observational Cohort Study

Abstract BACKGROUND To compare the influence of four different microkeratomes on myopic LASIK outcomes. METHODS Retrospective, observational cohort study. We compared 134 eyes treated with the IntraLase 60 kHz, 112 eyes treated with the Femto LDV Z6, 206 eyes treated with the FS200 and 98 eyes treated with the Hansatome zero compression microkeratome. All eyes were operated using the same surgical protocol with the same excimer laser (Wavelight Allegretto) and were allocated in refraction-matched groups. Uncorrected distance visual acuity, best corrected distance visual acuity and residual refraction were evaluated 1 and 7 days, 1 and 3 months postoperatively. RESULTS One day and one week postoperatively, uncorrected distance visual acuity was significantly lower in the FS200 group compared to others (P=0.0001). This difference disappeared at the 1- and 3-month postoperative visits. Significant differences were found among groups in terms of safety index (P=0.0001), residual sphere (P=0.0001) and residual cylinder (P=0.02) at the 3-months postoperative visit. No significant differences were found in corrected distance visual acuity or efficacy index. CONCLUSIONS According to our results, a slight delay in visual restoration after FS200 LASIK surgery might be expected. This delay was statistically significant at 1 day and 1 week postoperatively, but there were no differences from the 1-month visit onwards.

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A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens

European Journal of Ophthalmology ◽

10.5301/ejo.5001029 ◽

2017 ◽

Vol 28 (2) ◽

pp. 182-187 ◽

Cited By ~ 44

Author(s):

Ramón Ruiz-Mesa ◽

Antonio Abengózar-Vela ◽

María Ruiz-Santos

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Intraocular Lens ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Near Visual Acuity ◽

Reading Distance ◽

Continuous Range

Purpose: To evaluate and compare the visual outcomes and ocular optical performance of the PanOptix trifocal intraocular lens (IOL) and Symfony extended range of vision IOL. Methods: Sixty-eight eyes of 34 patients were divided into 2 groups: 20 patients with the PanOptix IOL and 14 patients with the Symfony IOL. Binocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCDVA), distance-corrected intermediate visual acuity (DCIVA) at 80 and 60 cm, and distance-corrected near visual acuity (DCNVA) at 40 cm were evaluated. Additionally, preferred reading distance with best-corrected distance and visual acuity at that distance, binocular defocus curves, mesopic and photopic contrast sensitivity, photic phenomena, and monocular total higher order aberrations (HOAs) were also measured. Results: The visual outcomes for PanOptix and Symfony IOL groups, respectively, were as follows: BCDVA: -0.03 ± 0.03 and -0.02 ± 0.03 logMAR; DCIVA at 80 cm: 0.06 ± 0.06 and 0.06 ± 0.04 logMAR; DCIVA at 60 cm: 0.06 ± 0.10 and 0.05 ± 0.04 logMAR; DCNVA: 0.04 ± 0.06 and 0.20 ± 0.07 logMAR (p<0.001). Similar preferred reading distances were found for both groups (37.0 ± 4.6 and 38.9 ± 5.7 cm, respectively). The visual acuities at those distances were 0.09 ± 0.08 and 0.19 ± 0.08 logMAR (p<0.001), respectively. The defocus curves showed significantly better outcomes for the PanOptix IOL from -2.0 to -4.0 D (p<0.001). No significant differences were found for contrast sensitivity, halometry, or HOAs between the groups. Conclusions: The PanOptix and Symfony IOLs showed comparable visual performance at distance and intermediate. However, the PanOptix IOL provided better near and preferred reading distance VAs and showed a more continuous range of vision than the Symfony IOL.

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Long term results of accelerated 9 mW corneal crosslinking for early progressive keratoconus: the Siena Eye-Cross Study 2

Eye and Vision ◽

10.1186/s40662-021-00240-8 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Cosimo Mazzotta ◽

Frederik Raiskup ◽

Farhad Hafezi ◽

Emilio A Torres-Netto ◽

Ashraf Armia Balamoun ◽

...

Keyword(s):

Visual Acuity ◽

Corneal Thickness ◽

Continuous Light ◽

Clinical Results ◽

Asymmetry Index ◽

Long Term Results ◽

Distance Visual Acuity ◽

Long Term Stability ◽

Uncorrected Distance Visual Acuity

Abstract Purpose To assess clinical results of the 9 mW/5.4 J/cm2 accelerated crosslinking (ACXL) in the treatment of progressive keratoconus (KC) over a span of 5 years. Methods The prospective open non-randomized interventional study (Siena Eye-Cross Study 2) included 156 eyes of 112 patients with early progressive KC undergoing the Epi-Off 9 mW/5.4 J/cm2 ACXL at the Siena Crosslinking Centre, Italy. The mean age was 18.05 ± 5.6 years. The 20-min treatments were performed using the New KXL I (Avedro, Waltham, USA), 10 min of 0.1% HPMC Riboflavin soaking (VibeX Rapid, Avedro, Waltham, USA) and 10 min of continuous-light UV-A irradiation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), Kmax, coma, minimum corneal thickness (MCT), surface asymmetry index (SAI), endothelial cell count (ECC) were measured, and corneal OCT performed. Results UDVA and CDVA improved significantly at the 3rd (P = 0.028), Δ + 0.17 Snellen lines and 6th postoperative month, respectively (P < 0.001), Δ + 0.23 Snellen lines. Kmax improved at the 6th postoperative month (P = 0.03), Δ − 1.49 diopters from the baseline value. Also, coma aberration value improved significantly (P = 0.004). A mild temporary haze was recorded in 14.77% of patients without affecting visual acuity and without persistent complications. Corneal OCT revealed a mean demarcation line depth at 332.6 ± 33.6 μm. Conclusion The 5-year results of Epi-Off 9 mW/5.4 J/cm2 ACXL demonstrated statistically significant improvements in UCVA and CDVA, corneal curvature and corneal higher-order aberrations which confers a long-term stability for progressive ectasia. Based on the results of the Siena Eye-Cross Study 2, the 9 mW/5.4 J/cm2 ACXL is a candidate to be the natural evolution of Epi-Off CXL treatment for the management of early progressive corneal ectasia, and thus optimize clinic workflow.

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Outcomes of a 320-degree intrastromal corneal ring segment implantation for keratoconus: Results of a 6-month follow-up

European Journal of Ophthalmology ◽

10.1177/1120672118818018 ◽

2018 ◽

Vol 30 (1) ◽

pp. 139-146 ◽

Cited By ~ 3

Author(s):

Guilherme Andrade do Nascimento Rocha ◽

Paulo Ferrara de Almeida Cunha ◽

Leonardo Torquetti Costa ◽

Luciene Barbosa de Sousa

Keyword(s):

Visual Acuity ◽

Spherical Equivalent ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Intrastromal Corneal Ring ◽

Corrected Distance Visual Acuity ◽

Ring Segment ◽

The Mean ◽

Corneal Tomography

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.

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