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Effect of induced corneal wavefront aberrations on monocular performance after bi-aspheric ablation profile for presbyopic corneal treatment using AMARIS with PresbyMAX module

Session Details

Session Title: Refractive

Session Date/Time: Sunday 16/02/2014 | 08:30-11:00

Paper Time: 08:36

Venue: Kosovel Hall (Level -2)

First Author: : DetlefHolland GERMANY

Co Author(s): :    Markus Poelzl   Tim Herbst   Tobias Ewering   Samuel Arba Mosquera   Detlef Uthoff  

Abstract Details


The aim of the study was to analyse the effects of induced corneal wavefront aberrations on monocular distance and near performance one year after bi-aspheric multifocal central presbyLASIK treatments for myopia and hyperopia with or without astigmatism, based on the creation of a central area for near vision and leaving the pericentral cornea for far vision.


Eye Hospital Bellevue, Kiel, Germany.


For 60 eyes of 30 patients treated with the PresbyMAX technique by one surgeon (D.U.), we analysed monocular corrected distance visual acuity (CDVA) and distance corrected near visual acuity (DCNVA), as well as univariate correlations of changes in CDVA and DCNVA with induced corneal wavefront aberrations.


Spherical aberrations are the main contributors for achieving multifocality, with a global optimum of -0.29 µm induced spherical aberration combined with +0.11 µm induced secondary spherical aberration (both inducing central myopia, and corresponding to a planned addition of +1.53 D). The changes in monocular DCNVA significantly correlated to induced coma (p<.01), induced spherical aberrations (p<.0005), induced pentafoil (p<.05), and induced root mean square (RMS) of the high-order aberrations (HOA) (p<.005), with the respective cut-off values being +0.03 µm for the induced coma (higher induced coma represents a gain of monocular DCNVA), -0.07 µm for the induced spherical aberrations, -0.00 µm for the induced pentafoil, and 0.19 µm for the induced RMS of the HOA (higher induced RMS represents a gain of monocular DCNVA). At 1-year follow-up, 100% of eyes achieved CDVA 0.1 logMAR (20/25) or better, 45% had obtained DCNVA 0.3 logRAD (J4) or better. Mean monocular CDVA degraded from -0.12±0.08 logMAR (20/15) to -0.07±0.09 logMAR (20/17) (p<.05). Mean monocular DCNVA improved from 0.45±0.19 logRAD (J7) to 0.40±0.17 logRAD (J5) (p<.05). 78% of eyes were within a range of 0.5D, and 94% within 1D sphere. Postoperative mean spherical equivalent refraction was -0.22±0.55D.


PresbyMAX inducing spherical aberrations due to a bi-aspheric multifocal ablation profile is an effective technique for simultaneous treatment of ametropia and presbyopia. The effect is additional achieved by inducing corneal aberrations. FINANCIAL INTEREST: ... is employed by a for-profit company with an interest in the subject of the presentation, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented