Corneal multifocality with excimer laser for presbyopia correction.
OBJECTIVE
To offer a comprehensive perspective on corneal multifocality created by excimer laser surgery, with the different approaches used for the purpose and its reported outcomes.


RESULTS
Three different approaches have been used for corneal multifocality: transitional multifocality, central presbyLasik (center for near) and peripheral presbyLasik (peripheral cornea for near). Although central presbyLasik creates a bifocal cornea, the other techniques increase the depth of focus based on the ablation of the peripheral cornea. Transitional multifocality creates intentionally an increase in coma aberration. According to the reported results, both central and peripheral presbyLasik obtain adequate spectacle independence simultaneously for far and for near. A neuroadaptation process is necessary for peripheral presbyLasik. Transitional techniques have a very limited use and very few outcomes reported.


CONCLUSIONS
The level of scientific evidence from the literature is enough to consider that presbyLasik is a useful tool in the correction of presbyopia. However, most of the techniques are still under development in clinical investigations and further clinical data will validate the outcomes reported for the different techniques.
Alió
Jorge L
JL
Vissum/Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain. jlalio@vissum.com
Amparo
Francisco
F
Ortiz
Dolores
D
Moreno
Luis
L
D003315:Cornea / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D005403:Fixation, Ocular; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D011305:Presbyopia / Q000601:surgery*; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity