Pseudoaccommodative Cornea Treatment Using the NIDEK EC-5000 CXIII Excimer Laser in Myopic and Hyperopic Presbyopes

PURPOSE: To investigate the refractive outcomes and spherical aberration of multifocal LASIK to create a distant-dominant center and near-dominant periphery in hyperopic, myopic, and emmetropic presbyopia. METHODS: One hundred ninety-five eyes with myopic presbyopia and 119 eyes with hyperopic or emmetropic presbyopia that underwent LASIK or epithelial LASIK (epi-LASIK) were assessed out to 3 months postoperatively. All eyes underwent the pseudoaccommodative cornea (PAC) treatment using aspheric ablation profiles and wavefront correction with the NIDEK CXIII excimer laser. Mean preoperative spherical equivalent refraction was -3.80+/-2.10 diopters (D) for myopic presbyopia and +1.00+/-0.92 D for hyperopic or emmetropic presbyopia. RESULTS: Mean postoperative spherical equivalent refraction was -0.40+/-0.77 D for myopic presbyopia and +0.15+/-0.62 D for hyperopic or emmetropic presbyopia. Functional vision, defined as 20/30 or better distance uncorrected visual acuity (UCVA) combined with J3 or better near UCVA, was achieved in 162 (83%) eyes with myopic presbyopia and 103 (87%) eyes with hyperopic or emmetropic presbyopia. An induction of 0.312 microm of spherical aberration was noted at 6 mm for myopic presbyopia treatments and 0.016 microm for hyperopic presbyopia treatments. CONCLUSIONS: The distance-dominant center used for PAC treatments is effective in emmetropic, myopic, and hyperopic presbyopia. The induced spherical aberration allows for depth of focus in patients with presbyopia.