Reversal of a presbyopic LASIK treatment

Abstract

We report on a 72 year-old pseudophakic patient who had been implanted with a monofocal intraocular lens, and who underwent a unilateral Supracor laser-assisted in-situ keratomileusis (LASIK) procedure to correct presbyopia and hyperopia. Uncorrected near visual acuity was improved, but the patient complained of glare, halo, reduced distance vision, and poor night driving vision due to treatment decentration. One year following the surgery, a reversal procedure was conducted with a wavefront-guided aspheric treatment to reverse the presbyopic correction while still maintaining the hyperopic correction. This resulted in 20/25 uncorrected distance visual acuity, and it eliminated the dysphotopsia symptoms. We believe that this is the first reported case demonstrating the ability to reverse the Supracor LASIK presbyopic procedure using wavefront-guided treatment in a case of an unsatisfactory outcome.

Keywords: LASIK; Supracor; presbyopic; reversal.

Figure 1

Corneal topographies. Notes: (A) Pre-Supracor shows with-the-rule astigmatism. (B) 1 year post-Supracor shows the steep Supracor bump to be slightly off-center. (C) Difference map pre-Supracor versus 1 year post-Supracor shows the magnitude and area of steepening caused by supracor and change in topography from (A) to (B). (D) 6 months post-reversal shows some flattening of the Supracor bump with recentration and decrease in the corneal steepness. (E) Difference map pre-Supracor reversal versus 6 months post-reversal shows where the flattening occurred specifically in the decentered steep area and change in topography from (B) to (D). Abbreviations: A–B, difference map showing change from topography A to B; B–D, difference map showing change from topography B to D; N, nasal; OS, oculus sinister (left eye); T, temporal.