Multifocal Corneal Ablation for Hyperopic Presbyopes

Abstract

To investigate the clinical results of multifocal wavefront-guided corneal ablation with a central near zone in hyperopic presbyopes. Twenty-seven patients (54 eyes) were analyzed retrospectively. Monocular near and distance uncorrected visual acuity (UCVA) and binocular near and distance UCVA were measured preoperatively, and the near addition power and the manifest refraction were obtained. Measurements of spherical aberration, coma, total higher order aberration, and contrast sensitivity for high and low photopic conditions were performed. All patients received multifocal corneal ablations with a central near zone using the VISX CustomVue System and were examined at 1 month (48 eyes), 2 months (42 eyes), and 6 months (28 eyes) after surgery. Of 14 patients, 9 (64.3%) achieved both 0.8 or better in binocular distance UCVA and 0.65 or better in binocular near UCVA, and the spherical equivalent refraction and near addition power decreased from +1.16+/-0.82 diopters (D) to +0.33+/-0.45 D and from 2.35+/-0.44 D to 1.42+/-0.62 D at 6 months after surgery, respectively. No significant changes were noted in total higher order aberration and contrast sensitivity, whereas spherical aberration coefficients (Z-12) changed from positive to negative. Multifocal wavefront-guided refractive surgery in presbyopia offered effective correction in hypermetropia and satisfactory near vision without significant increase in comeal total higher order aberration or significant decrease in contrast sensitivity.