Uncorrected binocular performance after biaspheric ablation profile for presbyopic corneal treatment using AMARIS with the PresbyMAX module

Abstract

Purpose: To analyze the uncorrected binocular performance after biaspheric multifocal central presbyopic laser in situ keratomileusis treatments.

Design: Retrospective, interventional case series.

Methods: setting. Private clinical practice. patient or study population. Three hundred fifty-eight presbyopic patients (43% males, 82 myopic), bilaterally treated, suitable for laser in situ keratomileusis, with monocular corrected distance visual acuity of 20/32 or better. intervention or observation procedure(s). PresbyMAX (Schwind Eye-Tech-Solutions GmbH and Co) biaspheric multifocal ablation. main outcome measures. Binocular uncorrected distance visual acuity (UDVA) and near visual acuity (UNVA) after surgery and their changes compared with corrected distance visual acuity and corrected near visual acuity before surgery.

Results: At 6 months, 76% of patients achieved a UDVA of 0.1 logarithm of the minimal angle of resolution (logMAR; Snellen equivalent, 20/25) or better, 91% of patients obtained a UNVA of 0.1 logarithmic of the reading acuity determination (logRAD) (p3) or better, and 99% of patients were within 1 diopter of defocus. Postoperative mean spherical equivalent was -0.17 ± 0.34 diopter. Ninety-six percent of patients achieved a UDVA of 0.2 logMAR (Snellen equivalent, 20/32) or better and a UNVA of 0.2 logRAD (p4) or better. Mean binocular corrected distance visual acuity degraded from 0.00 ± 0.01 logMAR (Snellen equivalent, 20/20) to a UDVA of 0.09 ± 0.07 logMAR (Snellen equivalent, 20/25). Mean binocular corrected near visual acuity degraded from 0.02 ± 0.01 logRAD (p2) to a UNVA of 0.07 ± 0.07 logRAD (p2).

Conclusions: Although optically the results are predictable, approximately 17% of the patients did not obtain objectively successful outcomes. In presbyopic patients without symptomatic cataracts, but with refractive errors, the 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 patients. Further investigation is necessary to evaluate the overall benefit of this procedure.