Retreatment Rate Following Supracor Treatment of Hyperopic Presbyopia

Abstract

Objective: To report the retreatment rate and safety of presbyopia treatment using the corneal laser in situ keratomileusis (LASIK) procedure, Supracor. Methods: In this case series, bilateral LASIK using the Supracor algorithm was performed on consecutive hyperopic presbyopic patients. All patients were followed for a minimum of six months postoperatively. The principal outcome measures were retreatment rate, safety, efficacy in terms of uncorrected distance visual acuity (UDVA) and uncorrected reading ability (vocational reading test), patient satisfaction, stability and predictability. Results: 76 eyes of 38 patients were treated. 42% of patients (16 patients) that were treated required at least one re-treatment. The mean preoperative manifest refractive spherical equivalent (MRSE) was +1.90 D ± 1.01 D. The mean MRSE following all treatments was -0.24 D ± 0.62 D. The UDVA was 20/20 or better in 38%, and was 20/30 or better in 91% of eyes following all treatments. 12% of eyes lost 1 line of Snellen corrected distance visual acuity (CDVA), and 3% lost 3 lines of Snellen CDVA following the primary treatment. 14% of eyes had lost 1 line of Snellen CDVA, and 4% of eyes had lost 3 lines of Snellen CDVA following all treatments. 92% of patients had uncorrected binocular near reading of J5 or better following the primary treatment. 97% of eyes had uncorrected binocular near reading of J5 or better following all treatments. Following all treatments, 82% of patients that underwent Supracor were pleased they had had the procedure performed. The mean follow-up period of patients in the study was twelve months. Conclusion: While there was a high level of near vision spectacle independence, the high retreatment rate with reduced CDVA in some cases is a cause for concern. The high retreatment rate with potentially reduced CDVA following Supracor may be due to a combination of blend zone, centration, and hyperpositive central zone issues.