Photopic pupillometry–guided laser in situ keratomileusis for hyperopic presbyopia
Accepted 1 September 2007.
Purpose
To evaluate a method of surgically treating presbyopia in hyperopic patients having laser in situ keratomileusis (LASIK) by selecting excimer ablation optical zone diameters based on the photopic pupil.
Setting
Private practice, Beverly Hills, California, USA.
Methods
This prospective analysis comprised 46 patients having hyperopic LASIK for presbyopia. The distance-dominant eye was treated with a standard 6.0 mm optical and 9.0 mm outer zone for full distance correction with no nomogram adjustment from the final preoperative manifest refraction. In the nondominant eye, an algorithm was used to select the optical and blend zone diameters and the optical zone size–dependent programmed amount of correction augmentation. Variables evaluated at the 6-month postoperative visit included preoperative and postoperative manifest refractive spherical equivalent (MRSE), refractive cylinder, and monocular and binocular near and distance uncorrected visual acuities. Patient satisfaction and spectacle dependence were also evaluated.
Results
In the near-corrected eye, the mean preoperative and postoperative MRSE was +1.10 diopters (D) ± 1.20 (SD) and −1.30 ± 0.56 D, respectively, and the mean refractive cylinder, −0.76 ± 0.91 D and −0.36 ± 0.33 D, respectively (P<.05). The mean uncorrected near acuity in the near-corrected eye was J10 preoperatively and J1 postoperatively (P<.0001) and the binocular mean uncorrected near acuity, J10 and J1, respectively (P<.0001). The mean uncorrected logMAR distance acuity in the near-corrected eye was +0.38 ± 0.31 (20/50) preoperatively and +0.36 ± 0.25 (20/50) postoperatively (P>.05). The mean binocular uncorrected logMAR distance acuity was +0.30 ± 0.30 (20/40) and +0.01 ± 0.08 (20/20) (P<.0001), respectively. The mean overall patient satisfaction score was 8.8 (scale 1 to 10). After LASIK, no patient reported using spectacles full time for near or distance and 15% reported part-time use.
Conclusion
Photopic pupillometry–guided LASIK may be an effective option when considering surgical treatment of presbyopia in hyperopic patients.
From a private practice, Beverly Hills, California, USA
Corresponding author: Kerry K. Assil, MD, 450 North Roxbury Drive, 3rd Floor, Beverly Hills, California 90210, USA.
Dr. Assil is a paid consultant to AMO. No author has a financial or proprietary interest in any material or method mentioned.
Presented at the Royal Hawaiian Eye Meeting, Waikoloa, Hawaii, USA, January 2005.
ABSTRACT