Abstract
PurposeThe aim of this systematic review was to synthesize and appraise the evidence of the benefits of presbyopic correction on the cornea for visual function.SummaryComprehensive search was conducted in MEDLINE using keywords like “presbylasik”, “presbyopic refractive surgery”, “corneal pseudoaccommodation” and “corneal multifocality”. We reviewed corrected and uncorrected visual acuities for distance and near (uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), distance corrected near visual acuity (DCNVA), corrected near visual acuity (CNVA)), along with the refractive outcomes in spherical equivalent (SE) and astigmatism comparing the differences observed between preoperative myopic and hyperopic patients, as well as among techniques.Thirty-one studies met the inclusion and quality criteria. Monovision provides excellent distance and near uncorrected acuities, but with a 17% retreatment and a 5% reversal rate. Initial multifocal ablations result in 12% loss of 2 or more lines of CDVA, and a 21% retreatment rate. Laser Blended Vision provides excellent UDVA, but with a 19% retreatment rate. Initial experiences with Supracor show moderate predictability and a 22% retreatment rate. Intracor results in 9% loss of 2 or more lines of CDVA. KAMRA provides excellent UDVA, with only a 1% retreatment rate, but a 6% reversal rate. Initial experiences with PresbyMAX provided excellent UNVA and DCNVA, showing excellent predictability and a 1% reversal rate.ConclusionsThe findings have implications for clinicians and policymakers in the health-care industry and emphasize the need for additional trials examining this important and widely performed clinical procedure.
Highlights
Surgical presbyopic correction has seen a tremendous increase in interest in the recent times
The outcomes for the myopic cases were better in terms of postoperative spherical equivalent (SE) (−0.19 D more residual myopia for preoperative myopes), binocular uncorrected near visual acuity (UNVA) and distance corrected near visual acuity (DCNVA), and change in corrected distance visual acuity (CDVA) (1 letter better for preoperative myopes)
We reviewed corrected and uncorrected visual acuities for distance and near (UDVA, UNVA, CDVA, DCNVA, corrected near visual acuity (CNVA)), along with the refractive outcomes in SE and astigmatism comparing the differences observed between preoperative myopic and hyperopic patients, as well as among techniques
Summary
Monovision is highly rated by patients even though binocular vision is compromised [47]. Pinelli et al [26] investigated the outcome of the correction of presbyopic patients with hyperopia using a peripheral presbyLASIK algorithm called Peripheral Multifocal LASIK (PML). UDVA: uncorrected distance visual acuity, UNVA: uncorrected near visual acuity, n: number of patients in the study, DCNVA: distance-corrected near visual acuity, CDVA: corrected distance visual acuity, CNVA: corrected near visual acuity, Retreat.: retreatment rate, M: months, Y: year(s), J: Jaeger scale for near vision, lns: Snellen lines. One can say that all corneal presbyopic correction methods have evolved to hybrid techniques that combine their original approach in different powers for either eye or the original approach with certain amount of monovision [61]. Author details 1SCHWIND eye-tech-solutions, Kleinostheim, Germany. 2Vissum Corporation, Alicante, Spain. 3Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
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