Presbyond Laser Vision Correction In A Patient With Longstanding Contact Lens Dry Eye

To describe the visual and refractive outcomes and two-year follow up for a 55-year-old female contact lens wearer with longstanding meibomian gland dysfunction having undergone PRESBYOND laser vision correction.

Preoperative manifest refraction with ocular dominance was performed along with assessment of the ocular surface. Suitability for surgery was confirmed and the patient was listed for BI LASIK PRESBYOND. The femtosecond Visumax® laser platform was used to create a corneal flap and the MEL90® excimer laser was used to ablate the cornea. Post-operative refraction was performed at one- and three-months. Depth of Focus curves (DoF), corneal wavefront aberration analysis, and retinal image quality using the modulation transfer functions (MTF) were assessed using the iTRACE® aberrometer.  At  one-month postoperatively subjective refraction was RE plano, LE-1.25 DS.   Monocular UDVA was RE 20/16, LE 20/80, binocular UDVA and UNVA were 20/16  and N4 respectively. Minimal corneal staining was observed and ocular comfort and satisfaction was high with the patient reporting fewer dry eye symptoms. Improved depth of focus and normal contrast sensitivity and stereoacuity was evidenced in both eyes postoperatively.  Patient reported spectacle independence.

The Presbyond® protocol was well-tolerated and a highly effective procedure in this case. Wavefront analysis demonstrated highly accurate postoperative refractive results with minimal higher order aberrations. Subjectively the ocular discomfort with CLW caused by MGD was improved, with minimal symptoms of evaporative dry eye disease DED postoperatively.  The patient achieved and has maintained excellent postoperative visual acuity. This case demonstrates Presbyond® delivers good all round vision for patients with presbyopia and maintains the refractive accuracy and safety of a standard LASIK procedure and can be a good option patients affected by contact lens-related dry eye issues.