Comparative Study Of Corneal Asphericity And Spherical Aberration Variations After Hyperopic Presbyopia Lasik Correction

To compare the visual outcomes of patients with presbyopic hyperopia, treated with bilateral presbyopic LASIK (Custom-Q mode), with current standard of monovision treatment.

A prospective comparative study of presbyopic and hyperopic patients undergoing a bilateral presbyopic laser in situ keratomileusis technique was conducted between May 2021 and November 2021.

Preoperative evaluation to determine dominant and non-dominant eyes, followed by contact lens simulation of mini-monovision was conducted for all patients. Custom-Q nomogram (Alcon Laboratories, Inc.) was applied to all non-dominant eyes for a negative aspheric ablation profile; the dominant eyes were treated with a positive aspheric ablation profile. Both at the time of preoperative evaluation and 1 month after the treatment, all the patients underwent UDVA and BCDVA, UNVA,  refraction, corneal asphericity (Q), full aberrometry with particular attention to spherical aberration (SA), dynamic pupillometry, contrast sensitivity and stereoacuity tests and quality of life evaluation (National Eye Institute Refractive Error Quality of Life).

Fifty-eight eyes of 29 patients were examinated in our study. Mean age was 50 ± 4 years. At 1 month post treatment, all the patients gained binocular UDVA of 20/20 and 20/20 binocular uncorrected intermediate visual acuity,  in line with previous similar studies. The 95% of patients gained 20/25 binocular UNVA, slightly better thant previous similar studies. Post-operative variations of Q values and SA values was statistically significant. Contrast sensitivity and stereoacuity  tests showed no significant variations. The quality of life test demonstrated full satisfaction in 100% of the patients.

The Custom-Q nomogram ablation treatment represents a better alternative to current standards of monovision. Negative aspheric ablation profile in the non- dominant eye provides better intermediate and near vision compared to contact lens monovision, confirming the results obtained with previous similar studies.