An evaluation of estimation methods for determining addition in presbyopes

Abstract

Purpose: The optical correction of presbyopia must be handled individually. Our aim was to compare the methods used in addition to the refractive near vision, with the final addition used in presbyopic patients. Methods: Eighty healthy subjects with a mean age of 49.7 years (range 40 to 60 years) were studied. Tentative near additions were determined using four different techniques: one-half amplitude accommodation with minus lenses (AAL); one-third accommodative demand with positive lens (ADL); balanced range of accommodation with minus and positive lenses (BRA) and crossed cylinder test with initial myopisation (CCT). The power of the addition was then refined to arrive at the final addition. Results: The mean tentative near additions were lower than the final addition for ADL and BRA addition methods. The mean differences between tentative and final additions were low for all the tests examined (less than 0.25 D). The intervals between the 95% limits of agreement differed substantially and were always higher than ±0.50 D. Conclusion: All the methods used displayed similar behavior and provided a tentative addition close to the final addition. The coefficient of agreements (COA) detected suggests that every tentative addition should be adjusted according to the particular needs of the patient.