Clinical research on the changes in corneal shape and wavefront abberation induced by SUPRACOR presbyopia treatment

Abstract

Objective To investigate the corneal shape and wavefront abberation outcomes of simultaneous correction for presbyopia in hyperopic eyes using the SUPRACOR technique. Methods This was a self-controlled study. Forty-eight hyperopic eyes (24 patients) with presbyopia underwent corneal treatment using the SUPRACOR technique, delivering a biaspheric multifocal ablation profile, PresbyLASIK. All patients were measured preoperatively and 12 months postoperatively for uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), refractive error, the overall wavefront aberrations (RMWFS), higher order aberrations (RMHOA) and third-order coma and fourth-order spherical aberrations to investigate the impact of this type of ablation model for treating corneal shape and eye aberrations. The data were analyzed with a matching t test and Wilcoxon signed rank test. Results The mean UDVA at 12 months postoperatively improved from 0.2(1.0 ~-0.0)logMAR to 0.1(0.5 ~-0.1)logMAR (Z=-2.54, P<0.01). The mean UNVA improved from 0.5(1.2~ 0.3)logMAR to 0.2(0.7 ~-0.1)logMAR at 12 months postoperatively (Z=-7.23, P<0.01). The postoperative central corneal mean power of 6.0 mm (K value) and the Q value were 44.60±1.61 D and -0.59±0.18, respectively, both with significant difference compare to preoperative measurement (t=-14.23, -13.28, P<0.01). For central corneal curvature, there was an increase in the vertically oblong aspherical shape. Overall, (pupil diameter 5, 6 mm) RMWFS was lower than the preoperative value (t=4.63, 4.61, P<0.01) and RMHOAS increased compared to the preoperative value (t=-5.98,-5.51, P<0.01). The vertical trefoil (Z3-3) decreased with a negative change in direction and the vertical coma (Z3-1) increased with a positive change. The spherical aberration (Z40) value had a negative reduction. Conclusion SUPRACOR presbyopia treatment in hyperopic eyes can increase central corneal curvature, a hyperprolate aspherical shape with a positive increase in third vertical coma and a negative increase in fourth-order spherical aberration, increasing the depth of focus. Key words: Presbyopia; Cornea; Lasers, excimer; Asphericity; Spherical aberration; Vertical coma