Pseudoaccommodative cornea treatment using the NIDEK EC-5000 CXIII excimer laser in myopic and hyperopic presbyopes.
To investigate the refractive outcomes and spherical aberration of multifocal LASIK to create a distant-dominant center and near-dominant periphery in hyperopic, myopic, and emmetropic presbyopia.



One hundred ninety-five eyes with myopic presbyopia and 119 eyes with hyperopic or emmetropic presbyopia that underwent LASIK or epithelial LASIK (epi-LASIK) were assessed out to 3 months postoperatively. All eyes underwent the pseudoaccommodative cornea (PAC) treatment using aspheric ablation profiles and wavefront correction with the NIDEK CXIII excimer laser. Mean preoperative spherical equivalent refraction was -3.80+/-2.10 diopters (D) for myopic presbyopia and +1.00+/-0.92 D for hyperopic or emmetropic presbyopia.



Mean postoperative spherical equivalent refraction was -0.40+/-0.77 D for myopic presbyopia and +0.15+/-0.62 D for hyperopic or emmetropic presbyopia. Functional vision, defined as 20/30 or better distance uncorrected visual acuity (UCVA) combined with J3 or better near UCVA, was achieved in 162 (83%) eyes with myopic presbyopia and 103 (87%) eyes with hyperopic or emmetropic presbyopia. An induction of 0.312 microm of spherical aberration was noted at 6 mm for myopic presbyopia treatments and 0.016 microm for hyperopic presbyopia treatments.



The distance-dominant center used for PAC treatments is effective in emmetropic, myopic, and hyperopic presbyopia. The induced spherical aberration allows for depth of focus in patients with presbyopia.
Uy
Edward
E
Advanced Vision Laser Center, Manila, Philippines. dadouymd@yahoo.com
Go
Rory
R
D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology; D003315:Cornea / Q000503:physiopathology*; D019781:Corneal Topography; D004215:Distance Perception / Q000502:physiology; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011305:Presbyopia / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology