RESUMO
PURPOSE: We performed zonal excimer laser photorefractive keratectomy in three eyes of three presbyopic patients using a specially designed mask, with a minimum follow-up of 24-months. METHODS: Two females (ages 59 and 48) and one male (age 55) were included in the study. The procedure was performed with a mask designed by one of the authors (GMN), applied to the Aesculap-Meditec Mel 60 excimer laser. The mask consists of a mobile diaphragm formed by two blunt blades. The aim in all the eyes was a presbyopic correction of 3.00 D. RESULTS: After an initial regression of 1.00 D, the presbyopic correction remained stable during the 36-month follow-up. The patients read at least J3 at normal reading distance without correction. Since the ablated zone was only about 15% of the total area of a 3.0 mm pupil, all three patients were also able to read with their preoperative presbyopic correction (using the untreated 85% of the pupillary area). CONCLUSION: Although only three eyes were treated with the zonal presbyopia mask presented here, the visual and refractive outcome appears promising in view of the relatively long follow-up time.
Assuntos
Córnea/cirurgia , Ceratectomia Fotorrefrativa/métodos , Presbiopia/cirurgia , Sensibilidades de Contraste , Feminino , Seguimentos , Humanos , Lasers de Excimer , Masculino , Pessoa de Meia-Idade , Refração Ocular , Resultado do Tratamento , Acuidade VisualRESUMO
BACKGROUND: For some patients, standard optical correction for presbyopia is not satisfactory. Using a specially designed mask, we developed a procedure for correcting presbyopia with excimer laser photorefractive keratectomy (PRK). METHODS: A mask consisting of a mobile diaphragm formed by two blunt blades was used to ablate a 10 to 17 microm deep semilunar-shaped zone immediately below the pupillary center, steepening the corneal curvature in that area. Three eyes of three presbyopic patients were treated, aiming at a near addition of +3.00 D. Follow-up time was 24 months. RESULTS: After an initial regression of 1.00 D during the first 6 months, the presbyopic correction remained stable for the duration of the follow-up period, enabling uncorrected near vision of J3 in all three eyes. Uncorrected distance visual acuity was not altered. Contrast sensitivity (Regan) was slightly decreased only at the 11% level. Videokeratography confirmed corneal steepening in the ablated area. CONCLUSION: The visual and refractive outcome of excimer laser PRK for presbyopia with the Aesculap-Meditec MEL 60 is promising, especially in view of the 2-year follow-up.
