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Correcting presbyopia using bi-aspheric multifocal ablation profile: 4 year follow-up

Poster Details

First Author: E.Eskina RUSSIA

Co Author(s):    V. Parshina   O. Kukleva   A. Davydova              

Abstract Details


Long term stability is an important indicator of the effectiveness for presbyopia correction. We see from published data, there is a lack of long-term follow-up, mostly it’s limited to 6 months - 1 year observation. Therefore, we decided to analyze the efficacy and safety of presbyopia correction in cases of myopia and hyperopia using PresbyMAX µ-monovision approach in combination with PRK within 4 years observation period. PRK is not that popular among surgeons because of delayed vision recovery. Nevertheless, using the PRK approach together with PresbyMAX significantly increases the capability of the method.


Laser surgery clinic SPHERE, Moscow, Russia


We analyzed a single step ametropia and presbyopia correction of 25 myopic and 24 hyperopic patients in age from 40 to 59 years with spherical equivalent (SE) from -6.50D to +4.25D and astigmatism up to 3 D. Uncorrected distance visual acuity (DUCVA) in groups were 0.08±0.01, 0.54±0.06 and near (NUCVA) 0.50±0.05, 0.16±0.01 respectively. 32 patients reached the end of the observation period. All presbyopic treatments were planned with CAM software and ablations were performed using the SCHWIND AMARIS excimer laser system. We analyzed DUCVA, NUCVA, BCVA and refractive outcome in terms of stability, predictability and safety.


Mean DUCVA for myops 0,71±0.03, 0,73±0.04 at 3, 48 months postop, 1 eye lost 1 line BCVA. DUCVA for hyperops 0,58±0.04, 0.74±0.05 respectively, 11 eyes lost 1-2 lines BCVA. NUCVA 0,78±0.03, 0,77±0.03 in myops and 0,70±0.03, 0,57±0,04 in hyperops at 3, 48 months, respectively. SE for Distance Eye (target emmetropia) -0,39±0,15D, -0,20±0,16D in myops, -0,89±0.25D, -0,27±0,09D hyperops at 3, 48 months postop respectively. For Near Eye (target -0,75D) -0,93±0,18D, -0,69±0,21D in myops and -1.48±0.21D, -0,96±0,15D in hyperops at 3 and 48 months postop.


PresbyMAX is an effective treatment of presbyopia in both myopic and hyperopic eyes. The safety for hyperopic patients is less than for myopic. But in both groups, is good enough. Refractive outcome stabilizes between 1 to 3 months after surgery for myops and only at 12 months for hyperops. DUCVA for myops has a statistically significant faster recovery than for hyperops at 3 months postop. NUCVA in hyperopia group decreases significantly during the observation time (at 3 to 48 months postop), while in myopia group it remains stable. Because of refraction stability it could be explained by epithelium reshaping.

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