Take the omni-focal approach

An omni-focal approach, combining an aspheric prebyopic treatment with a hyperopic ablation, looks promising as a method for improving near vision in hyperopes with presbyopia, according to Efekan Coskunseven from the Dunya Eye Hospital, Istanbul, Turkey.

Dr Coskunseven explained that the wavefront-guided treatment is dependent on pupil size and is designed to correct refractive errors, in addition to higher order aberrations. The aspheric ablation algorithm uses a combination of variable spot scanning (VSS), variable repetition rate (VRR), WaveScan aberrometry with Hartmann-Shack and Fourier technology and iris recognition to improve the accuracy of the ablation and to ensure correct placement on the cornea. All treatments were performed using the AMO/VISX Star S4 CustomVue excimer laser.

The global clinical results, so far, suggest that 100% of eyes treated with this system have achieved simultaneous binocular vision of 20/25 distance and J3 near vision by one year follow-up, with very little decline in contrast sensitivity. Dr Coskunseven, in his own case series, found that 90% of eyes achieved a near vision of J3 or better at six months.

Although some patients do experience a decline in distance vision, the loss is considered negligible. Overall, however, the treatment approach is showing promise and longer-term follow-up is required to assess the visual changes more thoroughly.