Abstract
Purpose To report the functional outcomes and reading speeds following PRESBYOND laser blended vision (LBV) using nonlinear aspheric ablation profiles with micro-monovision with the Carl Zeiss Meditec MEL 90 platform. Methods Data have been collected retrospectively for all patients who underwent PRESBYOND LBV using the MEL 90 excimer laser. Postoperative binocular uncorrected distance and near visual acuity, stereo-acuity, contrast sensitivity, and reading performance were compared with pre-op values measured with patient's progressive glasses. Mean follow-up was 6 ± 1.2 months. Results Sixty eyes of 30 patients (mean age 50.47 ± 6.43 years) were included. Of these, 18 patients were hyperopic and 12 patients were myopic with mean SE of 1.28 ± 1.38 D and −2.84 ± 1.86 D, respectively. At 6 months, the mean binocular UDVA was ≥−0.03 ± 0.06 log MAR and the mean binocular UNVA was ≥0.22 ± 0.04 log MAR. The uncorrected reading speeds (words per minute) at the preferred reading distance of 46.17 cm, 60 cm, and 80 cm were significantly better (p value <0.01), whereas the smallest letter size and reading acuities were comparable to the preoperative values (p > 0.05 for all distances). Uncorrected contrast sensitivity log values showed mild reduction; however, this was not statistically significant for any spatial frequency. There was a significant reduction in post uncorrected stereopsis to 89.67 arc sec, compared with pre-op corrected stereopsis (50.67 arc sec); however, it recovered fully with near correction (53.33 arc sec, p > 0.05 compared with pre). Conclusion PRESBYOND LBV resulted in significantly better reading speeds and satisfactory functional visual outcomes, without a permanent change in stereo-acuity and contrast sensitivity 6 months postoperatively.
Highlights
Introduction e PRESBYOND laser blended vision (LBV) procedure performed with MEL 90 excimer laser and the CRS-Master successfully combines monovision with extended depth of field achieved by the aspheric laser ablation profile combined with a micromonovision (−1.50 D) protocol to treat presbyopia
A total of 30 patients with mean age of 50.47 ± 6.43 years, who underwent bilateral treatment with PRESBYOND LBV for myopia (n 12 patients) or hyperopia (n 18 patients), with or without astigmatism were included in the study
The optimized aspheric ablation profile is intended to increase the depth of field of each eye, resulting in creation of a blend zone to enable continuous distance to intermediate to near vision between the two eyes
Summary
LBV procedure performed with MEL 90 excimer laser and the CRS-Master successfully combines monovision with extended depth of field achieved by the aspheric laser ablation profile combined with a micromonovision (−1.50 D) protocol to treat presbyopia. Using this protocol, the intended postoperative refraction is plano for the dominant eye and in the range of −1.00 to −1.50 D for the nondominant eye [1]. Typical visual function tests include assessment of visual acuity, contrast sensitivity, visual fields, tests for binocular vision, colour, depth, and motion perception etc. As the visual task-related ability, was assessed, which has not been described earlier in the context of this procedure
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