Exploring the Effect of Preoperative Stereopsis on Visual Outcomes in Hyperopic Presbyopes Treated with PresbyOND® Laser Blended Vision Micro-Monovision.

We investigated the effects of Laser Blended Vision (LBV) on binocular summation and stereopsis in the treatment of presbyopia and hyperopia. Using a unidirectional, retrospective longitudinal design, data from 318 patients who underwent the Zeiss PresbyOND® LBV surgical procedure at Tecnolaser Clinic Vision Ophthalmology Center in Seville, Spain, were analyzed. The findings indicate that stereopsis quality significantly influenced short-term post-operative visual outcomes in measures like Uncorrected Distance and Near Visual Acuity (UDVA and UNVA). However, the impact of stereopsis on visual outcomes appeared to diminish over time, becoming statistically insignificant at the 12-month post-operative mark. The study suggests that while stereopsis is a crucial factor in the short term, its influence on visual outcomes tends to wane in the long-term postoperative period. Future studies are essential to elucidate the enduring clinical ramifications of these observations.

Effectiveness of SMILE Combined with Micro-Monovision in Presbyopic Patients: A Pilot Study.

Binocular summation along all defocus range after a micro-monovision procedure has scarcely been studied. The aim of this pilot study was to evaluate the efficacy of SMILE combined with different levels of micro-monovision in presbyopic patients and to assess the binocular summation effect on contrast sensitivity defocus curves (CSDC) at the 6-month follow-up. Efficacy was assessed on the basis of visual acuity (VA) and stereopsis at far, intermediate, and near distances. Patient-reported outcomes (PROs) and binocular CSDC were also evaluated. Six patients completed the study with a programmed median anisometropia of 0.81 Diopter. The median binocular uncorrected VA was better than 0 logMAR at the three evaluated distances, and stereopsis was not impaired in any patient, achieving a median of ≤119 arcsec at any distance. CSDC increased binocularly after surgery, significantly in the range of -2 to -3 D (p < 0.05). No clinically relevant changes were observed in PROs compared with the preoperative period, and all patients achieved spectacle independence at intermediate/near distance and were likely or very likely to undergo the same surgery. In conclusion, micro-monovision with SMILE could be an effective procedure, with results that might be comparable to other laser correction techniques specifically designed for presbyopia correction.

Plasma Rich in Growth Factors (PRGF) in Transepithelial Photorefractive Keratectomy (TPRK).

To evaluate the usage of plasma rich in growth factor (PRGF) in transepithelial photorefractive keratectomy (TPRK) in low and moderate myopia, patients who underwent myopic and astigmatism TPRK with PRGF were involved in this retrospective, observational study. Subjects underwent a surgical procedure between February 2019 and June 2019. A three-month follow-up was recorded. Pain score was assessed with a visual analogue scale (0-10) and re-epithelialization time recorded. A total of 48 eyes from 24 patients were recruited. Mean uncorrected distance visual acuity (UDVA) was 20/20.31 (0.00 ± 0.02 LogMAR). A total of 98% of eyes did not change corrected distance visual acuity (CDVA) lines. Two percent of eyes lost one line of CDVA. Preoperative spherical equivalent was -2.67 ± 1.37 D and after three months changed to -0.21 ± 0.34 D, and 2% of eyes changed 0.50 D or more between one and three months. Pain score was 3.29 ± 0.61 (3 to 6) score points at day one and 0.08 ± 0.27 score points at day seven. Finally, re-epithelialization time was 2.50 ± 1.20 days. PRGF addition to conventional refractive treatment such as TPRK seems to alleviate immediate postoperative pain and positively contribute to corneal re-epithelization time.

Permavision intracorneal inlay after sixteen years. Regression of initial refractive hyperopia.

According to the available scientific literature, 77 patients underwent Permavision inlay worldwide, between 2004 and 2007. This study reported about the use of Permavision intracorneal inlay to increase the central corneal curvature and to correct hyperopia. A 32-year-old male patient went to the Tecnolaser Clinic Vision ® facilities for a refractive study. Preoperative refraction without cycloplegia was +6.00 D in the right eye (RE) and +4.00 in the left eye (LE). The surgery was performed for both eyes on December 2, 2003. The Carriazo-Barraquer mechanical microkeratome (Moria) was used to create a 180 µm-thick corneal flap with a diameter of 8.5 mm. After lifting the flap, the corneal inlay was placed centrally above the pupil and the flap was re-positioned. In this case report, the patient reverted to the initial refractive situation. The first refractive regression appeared at twelve-month follow-up. After sixteen years, it was found a decrease in maximum corneal curvature, an increase in mean corneal densitometry percentage, and no important changes in the central corneal thickness. In the reported case, the cornea reverted to its original shape. In the scientific literature, this is the first case report of a non-explanted Permavision inlay after sixteen years.

Refractive and Visual Outcomes of SUPRACOR TENEO 317 LASIK for Presbyopia in Hyperopic Eyes: 24-Month Follow-up.

PURPOSE: To analyze the efficacy, safety, predictability, and stability in hyperopic presbyopic laser in situ keratomileusis (LASIK) surgeries with the TENEO 317 algorithm (Bausch & Lomb Technolas, Munich, Germany). METHODS: Eighty eyes from 40 patients who underwent hyperopic and presbyopic LASIK in this retrospective, observational, and longitudinal study were included. All patients had a 24-month follow-up. Excimer laser treatment was performed with TECNOLAS Perfect Vision GmbH TENEO 317 software version 1.25 (Bausch & Lomb) with the PROSCAN platform for the distance dominant eye and the SUPRACOR mild platform for the near dominant eye. RESULTS: Mean age was 53.90 ± 4.84 years (range: 42 to 66 years). Postoperative uncorrected distance visual acuity (UDVA) was 0.00 ± 0.04 (20/19.97) for the dominant eye and 0.14 ± 0.05 (20/27.65) for the non-dominant eye. Postoperative uncorrected near visual acuity was 0.51 ± 0.17 (J9) for the dominant eye and 0.09 ± 0.06 (J1.5) for the non-dominant eye, whereas 2.5% of non-dominant eyes lost two lines of corrected distance visual acuity. Half of non-dominant eyes lost one line, and 2.5% of dominant and non-dominant eyes changed 0.50 D or more between 3 and 24 months. CONCLUSIONS: PROSCAN surgery in the dominant eye and SUPRACOR surgery in the non-dominant eye using the TENEO 317 algorithm demonstrated that the hyperopic presbyopic excimer laser surgery technique resulted in acceptable and stable outcomes after 24 months of follow-up. [J Refract Surg. 2019;35(9):591-598.].