LASIK for Hyperopic Astigmatism and Presbyopia Using Micro-monovision With the Carl Zeiss Meditec MEL80 Platform

Journal of Refractive Surgery - Tập 25 Số 1 - Trang 37-58 - 2009
Dan Z. Reinstein1, Darren Couch, Timothy J. Archer
1London Vision Clinic, London, UK. [email protected]

Tóm tắt

Purpose: To evaluate the monocular and binocular outcomes of LASIK for a micro-monovision protocol for the correction of hyperopic astigmatism and presbyopia. Methods: A prospective non-comparative case series included 258 eyes of 129 consecutive patients with hyperopic astigmatism and presbyopia who were treated with LASIK-induced micro-monovision. The CRS-Master software was used to generate ablation profiles for the Carl Zeiss Meditec MEL80 excimer laser. The target refraction was plano for distance eyes (dominant eye) and between −1.00 and −1.50 diopters (D) for near eyes. Patients were followed for 1 year. Results: Mean attempted spherical equivalent refraction (SE) correction was +2.54±1.16 D (range: +0.25 to +5.75 D). Mean attempted cylinder was −0.52±0.49 D (range: −0.00 to −3.25 D). Median age was 56 years (range: 44 to 66 years). Median follow-up was 12.5 months (range: 3.3 months [early retreatment] to 18.2 months). The retreatment rate was 22%. Outcome measures after all treatments were as follows. Mean deviation from the intended SE correction was +0.09±0.48 D, with 79% of eyes within ±0.50 D and 95% within ±1.00 D. The cylinder correction ratio was 1.23±0.63 and the error ratio was 0.67±0.65. Of the distance eyes, 86% achieved uncorrected visual acuity of 20/20 and 100% achieved 20/40. Binocularly, 95% of patients achieved 20/20 and 100% achieved 20/40. Eighty-one percent of patients could read J2 and 100% could read J5. Binocularly, 95% of patients achieved 20/20 and could read J5. No eyes lost 2 or more lines of best spectacle-corrected visual acuity. A statistically significant increase was noted in contrast sensitivity at 3 and 6 cycles per degree (cpd), with no reduction at 12 and 18 cpd. The average change in refraction between 3 months and 1 year was +0.11±0.36 D with a change of >1.00 D in 2.6% of eyes. Conclusions: This hyperopic micro-monovision protocol was a well-tolerated and effective procedure for treating patients with presbyopia in moderate to high hyperopia with corrections ranging up to +5.75 D. Contrast sensitivity was improved and the distance vision of near eyes was found to contribute positively to binocular distance vision compared to distance eyes monocularly. [ J Refract Surg . 2009;25:37–58.]

Từ khóa


Tài liệu tham khảo

10.3928/1081-597X-19970801-09

10.3928/1081-597X-19970801-08

10.1016/j.jcrs.2003.10.031

10.1016/S0886-3350(01)01001-X

10.3928/1081-597X-20040701-04

10.1016/S0161-6420(02)01255-1

10.1016/j.jcrs.2006.01.062

10.1016/j.jcrs.2003.09.022

10.1016/S0008-4182(03)80050-9

Horaková M, Vlková E, Loukotová V, Hlinomazová Z. Comparison of the two methods, LASIK and ICL in mild and high hyperopia correction--part one [Czech]. Cesk Slov Oftalmol. 2007;63:143–153.

10.1016/S0886-3350(02)01210-5

10.3928/1081-597X-20040701-03

10.3928/1081-597X-20070201-07

10.1016/S0002-9394(00)00606-1

10.3928/1081-597X-20030901-08

10.1016/S0886-3350(03)00462-0

10.3928/1081-597X-20060101-16

Waring GO III. Standard graphs for reporting refractive surgery. J Refract Surg. 2000;16:459–466.

10.3928/1081-597X-19980701-14

FDA. Checklist of Information Usually Submitted in an Investigational Device Exemptions (IDE) Application for Refractive Surgery Lasers 1997. Available at: http://www.fda.gov/cdrh/ode/2093.html. Accessed June 2007.

Adler F. Physiology of the Eye: Clinical Application. 8th ed. St Louis, Mo: Mosby; 1987.

Bennett AG, Rabbetts RB. Clinical Visual Optics. 3rd ed. Oxford, United Kingdom: Butterworth-Heinemann Ltd; 1998.

10.3928/1081-597X-20050902-08

10.3928/1081-597X-20010701-01

10.1016/S0161-6420(01)00647-9

10.3928/1081-597X-20070401-06

10.3928/1081-597X-20060201-09

10.3928/1081-597X-20061001-07

10.1016/j.ophtha.2004.09.017

10.3928/1081-597X-20050101-11

10.3928/1081-597X-20030901-09

FDA. WaveLight ALLEGRETTO WAVE™ Excimer Laser System (Hyperopia) (PMA) 2003. Available at: http://www.fda.gov/cdrh/pdf3/P030008b.pdf. Accessed February 2005.

FDA. Bausch & Lomb TECHNOLAS® 217a Excimer Laser System (Hyperopia) (PMA) 2003. Available at: http://www.fda.gov/cdrh/pdf/P990027S004c.pdf. Accessed February 2005.

10.1016/S0886-3350(02)02039-4

10.1016/S0886-3350(03)00415-2

10.1016/S0886-3350(03)00328-6

10.3928/1081597X-20080201-02

10.3928/1081-597X-20060101-10

10.3928/1081-597X-20040701-09

10.1001/archopht.1995.01100040054026

10.1016/S0161-6420(96)30494-6

10.1111/j.1475-1313.2007.00488.x

10.3928/1081-597X-20060501-06

FDA. Acrysof® ReSTOR® Apodized Diffractive Optic Posterior Chamber Intraocular Lenses Models MA60D3 and SA60D3 2005. Available at: http://www.fda.gov/cdrh/pdf4/p040020c.pdf. Accessed June 2007.

Thông tin
Thông tin xuất bản

Journal of Refractive Surgery

Tập 25 Số 1

37-58

Thông tin tác giả