title: Intrastromal femtosecond laser surgical compensation of presbyopia with six intrastromal ring cuts: 3-year results.
abstract: OBJECTIVE
  To assess over a 36-month period functional results of the modified INTRACOR femtosecond laser-based intrastromal procedure to treat presbyopia.
  
  
  METHODS
  20 eyes of 20 presbyopic patients with mild hyperopia were included. The INTRACOR procedure with a modified pattern (six concentric intrastromal ring cuts) was performed using the FEMTEC femtosecond laser (Bausch+Lomb/Technolas Perfect Vision, Munich, Germany). Patients were also randomly divided into three subgroups to compare the effect of three different small inner ring diameters (1.8/2.0/2.2 mm (Groups A/B/C)). Follow-up examinations were performed at 1, 3, 6, 12, 24 and 36 months, and included near and distance visual acuity tests, slit-lamp examinations and corneal topography.
  
  
  RESULTS
  Median uncorrected near visual acuity (UNVA) increased from 0.7/0.7/0.7 logMAR (Groups A/B/C) to -0.1/0.1/0.1 logMAR 36 months after surgery. Uncorrected distance visual acuity changed slightly from 0.1/0.2/0.1 logMAR to 0.2/0.3/0.1 logMAR. Losses of two lines of binocular corrected distance visual acuity (CDVA) were noted in 0/25/0% of eyes. Median spherical equivalent changed from 0.75/0.75/0.75 dioptres to -0.19/0.13/-0.19 dioptres. Overall patient satisfaction with the procedure was 80%.
  
  
  CONCLUSIONS
  INTRACOR with a modified pattern improved UNVA in all patients over a 36-month follow-up period. The possibility of reduced CDVA underlines the need for careful patient selection.
  
  
  BACKGROUND
  NCT00928122.
authors.affiliation: Department of Ophthalmology, International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory of Ophthalmic Pathology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Ramin
authors.initials: R
authors.lastname: Khoramnia
authors.affiliation: Department of Ophthalmology, International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory of Ophthalmic Pathology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Fitting
authors.affiliation: Department of Ophthalmology, International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory of Ophthalmic Pathology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Tanja M
authors.initials: TM
authors.lastname: Rabsilber
authors.affiliation: Department of Ophthalmology, International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory of Ophthalmic Pathology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Bettina C
authors.initials: BC
authors.lastname: Thomas
authors.affiliation: Department of Ophthalmology, International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory of Ophthalmic Pathology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Gerd U
authors.initials: GU
authors.lastname: Auffarth
authors.affiliation: Department of Ophthalmology, International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory of Ophthalmic Pathology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Mike P
authors.initials: MP
authors.lastname: Holzer
mesh_terms: D000368:Aged; D003319:Corneal Stroma / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011305:Presbyopia / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology*; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*
keywords: Cornea; Treatment Lasers; Treatment Surgery