ABSTRACT
BACKGROUND: To evaluate the safety and effectiveness of the Supracor excimer laser algorithm to treat hyperopic presbyopic patients using laser in-situ keratomileusis (LASIK). METHODS: This is a retrospective case review of patients diagnosed with hyperopia (Sphere ≥ +0.0 D and presbyopia reading add ≥ 1.0 D) who underwent Supracor excimer laser treatment on at least one eye for presbyopia correction from year May 2011 to May 2013. Binocular vision was further analyzed after patients were subdivided into three groups: Group A (n = 22 eyes, 11 patients) had Supracor on both eyes; Group B (n = 18 eyes, 18 patients) had Supracor in one eye and hyperopic LASIK on fellow eye; and Group C (n = 29 eyes, 29 patients) had Supracor in one eye and no treatment on the fellow eye. RESULTS: This study evaluated 58 patients wherein 69 eyes underwent Supracor presbyopic LASIK. Preoperatively, mean manifest refraction spherical equivalent (MRSE) of all eyes that underwent Supracor was +1.37 ± 0.72 D with mean uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA) of 20/50 (0.35 logMAR), 20/50 (0.35 logMAR), and J9 (0.61 logMAR), respectively. At 6 months postoperatively, mean MRSE was -0.43 ± 0.59 D with mean UDVA, UIVA and UNVA of 20/25 (0.13 logMAR), 20/20 (0.01 logMAR), and J1 (0.05 logMAR), respectively. Loss of two lines of best-corrected distance visual acuity (BCDVA) was seen in 6% of eyes. Mean corneal steepening of 1.0 D at the 3 mm zone and 0.7 D in the 5 mm zone was observed. Mean vertical coma increased from -0.02 to +0.10 while mean 4th order spherical aberration became more negative from 0.20 to -0.14. Mean binocular UDVA, UIVA, and UNVA are 20/20, 20/20 and J1, respectively, in all treatment groups at the 6 month postoperative follow-up. No significant differences in binocular UDVA (p ≥ 0.36), UIVA (p ≥ 0.19) and UNVA (p ≥ 0.56) among groups were seen. CONCLUSIONS: Supracor excimer laser algorithm is safe and effective for the treatment of presbyopia in hyperopes. Monolateral and bilateral Supracor treatments yielded similarly good binocular vision outcomes.
ABSTRACT
We report on a 72 year-old pseudophakic patient who had been implanted with a monofocal intraocular lens, and who underwent a unilateral Supracor laser-assisted in-situ keratomileusis (LASIK) procedure to correct presbyopia and hyperopia. Uncorrected near visual acuity was improved, but the patient complained of glare, halo, reduced distance vision, and poor night driving vision due to treatment decentration. One year following the surgery, a reversal procedure was conducted with a wavefront-guided aspheric treatment to reverse the presbyopic correction while still maintaining the hyperopic correction. This resulted in 20/25 uncorrected distance visual acuity, and it eliminated the dysphotopsia symptoms. We believe that this is the first reported case demonstrating the ability to reverse the Supracor LASIK presbyopic procedure using wavefront-guided treatment in a case of an unsatisfactory outcome.
