Excimer laser photorefractive keratectomy for presbyopia: 24-month follow-up in three eyes

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 (PRR). METHODS: A mask consisting of a mobile diaphragm formed by two blunt blades was used to ablate a 10 to 17 mu m 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 53 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.