Correction of pseudophakic presbyopia using Lasik with aspheric ablation profiles and a micro-monovision protocol.

PURPOSE: To evaluate the outcomes of Lasik with aspheric ablation profiles and a micro-monovision protocol for correction of presbyopia in pseudophakic patients. PATIENTS AND METHODS: This study included 50 pseudophakic eyes of 25 patients. Full ophthalmic examination, dominant eye tests and tests for tolerance of anisometropia (1 or 2 diopters) were done preoperatively. All cases were treated by Lasik with laser-blended vision technique. The dominant eye corrected to plano, and the nondominant eye corrected with near add in the range from 1.50 to 2.00 diopters. Excimer laser ablation was done using the MEL90 with a 250-Hz pulse rate (Carl Zeiss Meditec, Jena, Germany, Triple-A profile, Lasik mode). The follow-up period was 6 months with visits at 1, 3 and 6 months postoperatively. RESULTS: The mean postoperative uncorrected distant visual acuity at 1 month (0.74 ± 0.11) was significantly lower than the preoperative level (0.84 ± 0.14) (p < 0.001). But it improved at the 3rd (0.80 ± 0.09) and 6th months (0.82 ± 0.10) with no significant difference with the preoperative level (p = 0.344). The mean uncorrected near visual acuity was significantly higher at the 1st (2.94 ± 1.63 J), 3rd (2.95 ± 1.82 J) and 6th (2.92 ± 1.83 J) postoperative months than the preoperative level (2.26 ± 1.48 J) (p < 0.001). Insignificant change in stereopsis was found after surgery (p = 0.849). The micro-monovision was well tolerated (95.8%). CONCLUSION: Lasik with aspheric ablation profiles and a micro-monovision protocol is an effective option for presbyopia correction in pseudophakic patients.

Circular YAG laser anterior capsulotomy for anterior capsule contraction syndrome.

PURPOSE: To evaluate circular neodymium: YAG laser incision in cases of anterior capsular contraction syndrome (ACCS) by comparing it to radial Neodymium: YAG laser incision as for efficacy and safety. SETTINGS: Ophthalmology Department, Benha University Hospitals. METHODS: The study was done on 74 eyes of 66 patients with symptomatic ACCS. Eyes were randomly allocated to one of the two groups. Group I were treated by circular YAG laser anterior capsulotomy. Group II were treated by radial YAG laser anterior capsulotomy. All cases passed a full ophthalmic examination before laser capsulotomy, 1 week, 1 month, 6 months and 12 months after laser. RESULTS: BCVA at the 1st week and the 1st month after the capsulotomy did not show any significant difference between the two groups; however at the 3rd and 6th months, the circular group showed better visual acuity than the radial group (p 0.001 and < 0.001, respectively). All post-YAG UCVA and BCVA were significantly higher than pre-YAG UCVA and BCVA in both groups. IOL decentration occurred in two cases in radial group. Circular group had significantly higher percentage of contraction relief (94.4%) than the radial group (66.7%) with p value 0.003. CONCLUSION: Circular Nd:YAG anterior capsulotomy is more effective and safe than radial capsulotomy in 1-year follow-up.