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Near visual acuity and patient-reported outcomes in presbyopic patients after bilateral multifocal aspheric LASIK excimer laser surgery.

Abstract：

PURPOSE:To determine improvement of near visual acuity by bilateral multifocal aspheric LASIK treatments in presbyopic patients. SETTING:Goethe-University, Frankfurt, Germany. DESIGN:Prospective, non-randomized trial. METHODS:Thirty presbyopic patients underwent laser in situ keratomileusis (LASIK) treatment with a multifocal aspheric ablation profile using an excimer laser (PresbyMAX). The first 15 patients received a multifocal aspheric ablation profile combined with micro-monovision. For the consecutive 15 patients, less depth of focus (DOF) was included on the distance eye (hybrid). OUTCOME PARAMETERS:Uncorrected (UDVA) and corrected distance visual acuity (CDVA), uncorrected (UIVA) and distance-corrected intermediate visual acuity (DCIVA), and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity; manifest refraction spherical equivalent (MRSE); subjective quality of vision; and spectacle independence RESULTS:: Binocular CDVA changed from -0.16±0.10 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.05±0.20 logMAR UDVA and -0.06±0.14 logMAR CDVA (p = 0.000, p = 0.001) 1 year postoperatively. Near visual acuity improved from 0.47±0.13 logMAR (DCNVA) and 0.48±0.26 logMAR (UNVA) to 0.19±0.19 logMAR (DCNVA, p<0.001) and 0.05±0.15 logMAR (UNVA, p<0.001). The hybrid- and the µ-monovision group did not differ statistically except for a better DCNVA in the µ-monovision patients (0.21±0.15 logMAR vs 0.34±0.17 logMAR, p=0.034). Of the hybrid- and µ-monovision patients, 21 (72%) and 12 (41%) had a binocular CDVA and UDVA of 20/20 or better, 8 (28%) patients lost 1 line of CDVA, 3 (10%) lost 2 lines, 4 (14%) lost 3, and 2 (7%) lost 4 lines of CDVA. CONCLUSIONS:The PresbyMAX laser seemed to satisfy most of the patients even though they experienced a loss of CDVA. The gain of near visual acuity and therefore reported less need of spectacles appeared to compensate for this loss.

journal_name

J Cataract Refract Surg

journal_title

Journal of cataract and refractive surgery

authors

Kohnen T,Böhm M,Herzog M,Hemkeppler E,Petermann K,Lwowski C

doi

10.1097/j.jcrs.0000000000000198

subject

Has Abstract

pub_date

2020-03-30 00:00:00

eissn

0886-3350

issn

1873-4502

pub_type

杂志文章

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Near visual acuity and patient-reported outcomes in presbyopic patients after bilateral multifocal aspheric LASIK excimer laser surgery.