TREATING HYPEROPIA AND PRESBYOPIA: CORNEAL RESHAPING WITH LENTICULE TRANSPLANTATION

To assess visual acuity improvement in hyperopia and presbyopia patients after myopic lenticule transplantation by changing Q value.

Department of Refractive Surgery, Eye Hospital, Prishtina, Kosovo

This retrospective study involved 40 eyes of 30 patients (18 males and 12 females) aged 20 to 50 years, with refractive errors between +4.0 D and +6.50 D and astigmatism ranging from +0.75 D to +1.75 D. 10 patients received bilateral treatment for presbyopia, while 20 patients underwent unilateral treatment for hyperopia. Their corneal thickness ranged from 450 μm to 550 μm. Donor lenticules were obtained from patients aged 20-25 years who underwent small incision lenticule extraction surgery, with refractive errors between -4.50 D and -7.00 D (no astigmatism) and thicknesses of 90 to 140 microns. The diameter of donor lenticules was set 0.5 mm larger than the recipient's mesopic pupil size to prevent accommodation issues. An 8 mm stromal pocket was created in the recipient cornea with a cap thickness of 130 µm and a 2.09-mm incision. Lenticules were transplanted into the pocket based on corneal topography and adjusted according to the low K value to correct astigmatism. Follow-up assessments over 1 year included evaluations of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA) at 35 cm, corrected near visual acuity (CNVA), uncorrected intermediate visual acuity (UIVA) at 70 cm, slit-lamp biomicroscopy, corneal topography, anterior segment optical coherence tomography, and pachymetry.

The Q value improved from −0.50 ± 0.04 log MAR preoperatively to −0.78 ± 0.05 log MAR at 1 year (p < 0.001). UDVA increased from 0.63 ± 0.08 log MAR preoperatively to 0.07 ± 0.02 log MAR at 1 year (p < 0.001). UNVA improved from J7 to J2 at 35 cm and UIVA from J6 to J3 at 70 cm.

By changing the corneal shape, this method treats distance, intermediate, and near vision.