Early Outcomes Utilizing Controlled Positive Spherical Aberration To Treat Myopic Presbyopes With Schwind Technology

To outline the early postoperative visual outcomes utilizing positive spherical aberration to create centre distance, peripheral near PresbyMAX profiles (SCHWIND eye‑tech‑solutions GmbH, Kleinostheim, Germany) in myopic patients.

Cathedral Eye Clinic, Belfast, Northern Ireland, UK. 

This retrospective review chart aims to include at least 20 patients who had PresbyMAX reversal. PresbyMAX reversal provides a centre distance profile which allows accurate control of positive spherical aberration in presbyopic patients. The general application used in this work involves Presbymax reversal femtoLASIK for both eyes with the dominant eye targeted to emmetropia and the non-dominant eye with a target of less than -1D, and an addition of 1.25D to 1.50D. The uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity and refractive error were assessed 3 months postoperatively.

So far, only 2 patients completed the follow-up schedule. Patient A had UDVA of -0.08logMAR in the dominant right eye, 0.5logMAR in the left, and -0.1logMAR binocularly. UIVA was 0.1logMAR in each eye and binocularly. UNVA was 0.5 and 0logMAR in the right and left eyes, and 0logMAR binocularly. Refractive error was right plano, left -1.5D. Reports blurred distance vision in the left eye, and glare at night. Patient B had UDVA of 0 and 0.2logMAR in the right and left eyes, and 0logMAR binocularly. UIVA was 0logMAR in the right, and 0.2logMAR in the left and binocularly. UNVA was 0.5, 0.2 and 0.1logMAR in the right and left eyes, and binocularly. Refractive error was right +0.25/-0.50x165, left -1.25DS. No adverse events occurred. 

The PresbyMAX reversal positive spherical approach for myopes provided a range of clear vision from distance to near. Some cross blur was reported at this early postoperative stage in the monocular case. Presbymax hybrid appears to show an instantaneous adaptation to cross blur, when compared to the monocular approach.

More cases will be presented at the ESCRS conference.