Laser blended vision for presbyopia: results after 3 years
First Author: CristianFalcon SPAIN
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As Multifocal intraocular lens implantation in relatively young patients with clear lens can produce a decrease of contrast sensitivity and even important complications, LASIK is an interesting option in patients with presbyopia, including those with emmetropia. Laser Blended Vision for Presbyopia by Zeiss is a wavefront-guided treatment that has several mechanisms to increase near vision keeping a good vision for distance as well: monovision, depth of field, spherical aberration, vertex centration, retinal image processing, neural summation, blur adaptation and neural suppression. We studied the results of the first 173 patients that underwent this treatment in our Clinic.
: Retrospective study of the first 173 patients that underwent LASIK with the wavefront-guided Laser Blended Vision Programme for Presbyopia by Zeiss during the last 3 years in our Clinic (Optima Laser Eye Clinic Valencia).
We studied the first 173 patients with presbyopia that underwent LASIK with the wavefront-guided Laser Blended Vision Programme by Zeiss in our Excimer Laser Zeiss Mel-80 during the last 3 years. The programme has a non-linear aspheric ablation profile that increases the spherical aberration in both eyes. It also produces a slight myopia of -1.5 spheres in the non-dominant eye. We analysed the results and patient’s satisfaction. The patients were separated into two groups: less than 50 years old and 50 years or more. The follow-up was between 1 to 28 months. We also separated two groups: follow-up less than 12 months and follow-up 12 months or more. We analysed the efficacy, security and predictability of the procedure.
79 male and 94 female patients between 42 and 69 years old. Only 8 patients (4.62%) were between 42 and 44; 55 (31.79%) were between 45 and 49; 110 patients (63.58%) were 50 years or more. 9 patients underwent the surgery in the non-dominant eye only.12 (6.94%) patients were emmetropic (0.5 o less spherical equivalent), 42 (24.28%) were myopic or astigmatic myopic and 119 (68.79%) were hyperopic or astigmatic hyperopic.136 patients (78.61%) had a pre-op near vision between J4 and J10. 171 patients (98.84%) had a post-op near vision between J1 and J3; 150 (86.7%) had J1 (efficacy).Post-op visual acuity without correction for distance was 20/20 or more in 159 patients (91.91%) (both eyes open).The predictability for 0.5 diopter was 87.86%. Security 99.7% (337 eyes) one eye of a diabetic patient lost 2 lines BCVA. 93.64% was satisfied with the procedure, 2.89% eye-glasses for certain activities, 1.73% dry eye, 0.58% nonspecific lack of adaptation, no severe complication. 3.47% did not achieve their expectations. 24 patients (13.87%) needed an enhancement, 18 of them (75.5%) only of one eye, 88.89% of them, the non-dominant eye. 49 patients (28.32%) had a longer than 12 months follow-up, 95.92% was still satisfied.
Laser Blended Vision for presbyopia has a high percentage of satisfaction for emmetropic, myopic, hyperopic and astigmatic patients with a fast adaptation and very good outcomes in visual acuity for distance and near. The results are as good for younger patients with presbyopia as for older patients. Satisfaction is not always related to visual acuity, image processing is important to give a comfortable vision. Achieving all patients’ expectations is not always possible. The higher percentage of enhancements due to a lesser accommodation capacity and the higher patient’s expectations compared to standard LASIK could influence in patient’s satisfaction. Definitely, the patient’s satisfaction improves with the retreatment. Laser Blended Vision is an excellent option for patients with presbyopia avoiding an intraocular procedure. FINANCIAL INTEREST: NONE