CK improves near vision in post-LASIK presbyopic emmetropes


At three months, 88% had monocular uncorrected near vision of J2 or better and 95% had J3 or better. A total of 84% were able to read newspaper-sized print without spectacles and 84% were satisfied or very satisfied with the results

Patients who underwent myopic LASIK in earlier years do not differ from myopes who never underwent a LASIK procedure - both become presbyopic with advancing age and require add spectacles, bifocals, or progressive lenses for near vision. Post-LASIK presbyopes, however, may be more likely to seek a surgical solution for their near vision deficiency since they once sought refractive surgery to correct their myopia. But, in my experience, patients of presbyopic age are more concerned about safety than their younger counterparts seeking LASIK for myopia.

The ViewPoint CK System has been approved by the US FDA for the treatment of mild to moderate (0.75 D to 3.00 D) previously untreated, spherical hyperopia in persons 40 years of age or older, as well as for improving near vision in presbyopic low hyperopes or emmetropes through induction of a mild myopia in the non-dominant eye. A multicentre study that is evaluating the treatment in presbyopes who have previously received LASIK, is currently ongoing. At the study's conclusion, it is hoped that the system will receive FDA approval for this new indication.

Patients enrolled in the ongoing multicentre post-LASIK study must be emmetropic presbyopes who had LASIK treatment for 1.00 to 6.00 D of myopia at least one year earlier. After LASIK, these patients must have a manifest refractive spherical equivalent of +0.50 D to-0.50 D, 0.75 D or less of cylinder, residual central pachymetry of 400 μm or more, and peripheral pachymetry of 560 μm or more.

They will all be treated conservatively, receiving 1 ring of CK treatment (8 CK treatment spots) at the 8 mm optical zone in the non-dominant eye for a 1.25 D add. The contralateral eye will not be treated. A total of 150 post4LASIK presbyopic patients will be enrolled in the study and followed for one year. Here we present preliminary results from this study.

Results so far say...

At the three-month time point, 72 patients with a mean age of 52 and a mean pre-LASIK manifest refractive spherical equivalent (MRSE) of-3.38 D have been treated with NearVision CK. The mean time between LASIK and CK was 5.1 years. The mean refractive effect at three months was 1.17 D ± 0.45, which closely matches the target effect of 1.25 D. The spherical equivalent was-0.30 D preoperatively.

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