Visual and Refractive Outcomes Following Laser Blended Vision With Non-linear Aspheric Micro-anisometropia (PRESBYOND) in Myopic and Hyperopic Patients

Abstract

PURPOSE: To report 6-month visual and refractive outcomes following PRESBYOND Laser Blended Vision (Carl Zeiss Meditec) treatment using non-linear aspheric micro-anisometropia laser in situ keratomileusis (LASIK) for the correction of myopic and hyperopic presbyopia. METHODS: A retrospective, non-comparative study of 139 consecutive patients with a mean age of 53.13 ± 5.84 years (range: 42 to 70 years) treated with LASIK-induced micro-anisometropia using the MEL 90 excimer laser and VisuMax femtosecond laser (both Carl Zeiss Meditec). The target refraction was plano for distance eyes (dominant eye) and between -0.50 and -1.50 diopters (D) for near eyes. Patients were observed for 6 months. RESULTS: A total of 278 eyes (78 myopic and 200 hyperopic) from 139 patients completed the study. Mean preoperative spherical equivalent (SE) was -3.40 ± 1.83 D (range: -0.50 to -8.25 D) for myopic eyes and +1.61 ± 0.98 D (range: -1.25 to +4.63 D) for hyperopic eyes. Mean postoperative SE refraction of distance eyes was +0.20 ± 0.35 D (range: -0.38 to +1.00 D) and -0.14 ± 0.42 D (range: -1.38 to +0.88 D) for myopic and hyperopic eyes, respectively. Mean postoperative SE refraction of near eyes was -0.90 ± 0.44 D (range: -0.13 to -2.25 D) and -1.21 ± 0.48 D (range: -0.13 to -2.25 D) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected near visual acuity was 0.15 ± 0.16 logMAR (range: 0.00 to 0.50 logMAR) and 0.10 ± 0.15 logMAR (range: 0.00 to 0.60 logMAR) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected distance visual acuity was -0.08 ± 0.09 logMAR (range: -0.10 to 0.20 logMAR) and -0.06 ± 0.12 logMAR (range: -0.10 to 0.40 logMAR) for myopic and hyperopic eyes, respectively. Stereoacuity was better than 100 seconds of arc in 79% of myopic eyes and 85% of hyperopic eyes and all vision quality scores were greater than 90 of 100. No eyes lost two or more lines. CONCLUSIONS: The non-linear aspheric micro-anisometropia protocol resulted in safe and effective visual outcomes in patients with both myopic and hyperopic presbyopia.