Results of presbyopia correction with multifocal profile application on the cornea by photorefractive keratectomy in hyperopic patients

Aim. To compare the efficacy, safety, and predictability of simultaneous hyperopia and presbyopia correction using photorefractive keratectomy (PRK) with the application of a bi-aspheric multifocal profile on the cornea using PresbyMax software and hyperopia correction using LASIK.

Methods. Overall, 50 patients were divided into two groups: 25 patients (50 eyes) in group 1 underwent PRK with bi-aspheric multifocal profile application on the cornea using PresbyMax software for simultaneous hyperopia and presbyopia correction. Group 2 included 25 patients (50 eyes) who underwent LASIK with aspheric profile application on the cornea for hyperopia correction.

Results. One year after surgery in group 1, binocular distance uncorrected visual acuity (DUCVA) was 0.96 ± 0.16, near uncorrected visual acuity (NUCVA) was 0.77 ± 0.17, and intermediate uncorrected visual acuity (IUCVA) was 0.64 ± 0.15. Visual acuity loss of up to 0.2 was found in two eyes (4%). Target refraction in the dominant eye (emmetropia) was obtained in 72% of patients; in 28% of cases, a shift up to –0.75 D was observed. Target refraction in the non-dominant eye was found in 68% of patients, 12% of patients had a shift from the target refraction of –0.50 D, and 20% of patients of –0.75 D. Spherical aberration in the 6-mm zone was –0.22 ± 0.17 μm. One year after surgery in group 2, binocular DUCVA was 1.0 ± 0.10, NUCVA was – 0.37 ± 0.16, and IUCVA was – 0.43 ± 0.12. No monocular best corrected distance visual acuity loss was found. A myopic shift from the planned target (emmetropia) of –0.50 D was established in 4% of patients. Spherical aberration in the 6-mm zone was –0.10 ± 0.08 μm.

Conclusion. PRK with bi-aspheric multifocal profile application, unlike LASIK, not only achieves hyperopia correction but also improves near visual acuity in patients of presbyopic age.