Correction of pseudophakic presbyopia using Lasik with aspheric ablation profiles and a micro-monovision protocol
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ORIGINAL PAPER
Correction of pseudophakic presbyopia using Lasik with aspheric ablation profiles and a micro-monovision protocol Mohamed Nagy Elmohamady Elham Abdelazim Gad
. Walid Abdelghaffar . Ahmed Sherin Mostafa Bayoumy .
Received: 15 May 2020 / Accepted: 16 August 2020 Ó Springer Nature B.V. 2020
Abstract 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 laserblended 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
M. N. Elmohamady (&) W. Abdelghaffar A. S. M. Bayoumy E. A. Gad Ophthalmology Department, Faculty of Medicine, Benha University Hospital, Benha, Egypt e-mail: [email protected]
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.
Introduction Presbyopia, a Greek word means ‘‘old eyes,’’ refers to the age-related deterioration of the accommodative ability of the crystalline lens. This leads to recession of the near point of accommodation around the age of 40 years [1, 2]. Not all presbyopic eyes are ‘‘old eyes,’’ some ocular conditions like traumatic cataract, panretinal laser photocoagulation, and pseudophakia instigate to presbyopia. Systemic diseases as diabetes mellitus, cardiovascular accidents, multiple sclerosis, myasthenia gravis and anemia are considered independent risk factors for early presbyopia. Drugs like antidepressants, diuretics, antihistaminics and antipsychotics may cause considerable loss of accommodation as a side effect [3, 4]. Proper treatment of presbyopia turned out to be a priority because people stay active and inevitably continue to work longer than ever before. The
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