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Session Title: Presbyopia Correction
Session Date/Time: Monday 07/10/2013 | 16:30-18:15
Paper Time: 17:18
Venue: Emerald (First Floor)
First Author: : D.Holland GERMANY
Co Author(s): : M. Pölzl D. Hepper D. Uthoff
Presbyopia still is one of the greatest challenges in ophthalmology. Apart from MIOL implantation which in the moment is the most widely used surgical therapy other treatment options like intracorneal inlays and scleral expanding systems are a treatment option. But all this method have their limitations. In MIOL implantation there is still the risk of an intraocular surgery, e.g. endophthalmitis. Besides this not all patients are willing to undergo intraocular surgery if other options are available. One of these options is monovision or Presbylasik with the excimer laser. We investigated the outcomes for simultaneous correction of presbyopia and ametropia by biaspherical Presby-Lasik technique based on the creation of a central area hyperpositive for near vision and leaving the midperipheral cornea for far vision with a concept called PresbyMax® on the Schwind Amaris plattform. At the beginning both eyes were treated with the same ablation profile, than regarding the first results a change to a micro-monovision concept was performed to improve distance visual acuity.
The Study includes 128 eyes of 64 patients, who have been treated with the PresbyMax® concept at the Augenklinik Bellevue.
All presbyopic patients underwent FEMTO-LASIK and were assessed up to 3 years postoperatively. Mean patient age was 52.5 years (deviation: ± 11.5 years). The preoperative sphere ranged from -6.50 to +5.25 dpt. and the astigmatism from 0.25 to 4.5 dpt. All eyes underwent cornea treatment using the PresbyMAX® software delivering bi-aspherical multifocal ablation profiles developed by Schwind Eye-tech-solutions (Kleinostheim, Germany). All Flaps were created by Ziemer LDV Femtolaser (Port, Switzerland). The dominant eye was treated with up to 0,75dpt less addition then the non-dominant eye for the central near vision area and the non-dominant eye had increased myopic target refraction in the peripheral distance zone.
Mean DUCVA improved from 0.50 to 0.10 logMar. DUCVA binocular was 0.0 logMar. The mean NCVA was 0.0 logRAD preoperative and the postoperative NUCVA was 0.0 logRAD too. The mean postoperative sphere in the myopic group was -0.13 dpt and mean cylinder was 0.50 dpt. In the hyperopic group the mean postoperative sphere was 0.1dpt and the mean cylinder 0.51 dpt. Safety improved using the micro-monovision concept. Monocular loss of one line improved from -43% to -17% e.g..
In presbyopic patients without symptomatic cataract, but refractive errors PresbyMAX® will decrease the presbyopic symptoms and correct far-distance refraction in the same treatment offering spectacle-free vision in daily life in most of the treated patients.
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