43
EW REFRACTIVE SURGERY
February 2016
Contact information
Ahmed: ike.ahmed@utoronto.ca
Dean: info@eyeinstitute.co.nz
Pallikaris: pallikar@med.uoc.gr
Addressing the issue of incon-
sistent results in reported findings
on presbyLASIK, Dr. Pallikaris and
colleagues stated that future studies,
to be more conclusive, should have
a patient follow-up period of at least
1 year or more, and reporting the
results while following certain stan-
dards would be a great help to the
refractive community.
"[That's] because neural adap-
tation and corneal regression are
long-term effects, which will not be
noticed with 3 or 6 months follow
ups," they explained. "Apart from
the standard refractive surgery
reporting, studies on presbyopia
correction should include detailed
near vision results and especially
combined near/far visual acuities
and spectacle independence after
the last follow up as a final metric of
success."
In clinical practice, however,
some patients are willing to accept
the tradeoffs, according to Dr. Dean.
"Some tradeoffs are getting lesser
with time. People wanting presby-
LASIK are the ones driving. If they
ask me for it, I present them with a
range of options," he said.
According to published lit-
erature in 2009 on presbyLASIK,
authors have identified that expecta-
tion management and patient selec-
tion are critical factors that should
be strictly adhered to in presbyLASIK
compared to other conventional
refractive procedures.
"A test with multifocal contact
lenses or trial frames that creates
slightly defocused images can be
used to simulate postoperative visual
impressions and verify patient ac-
ceptance as is commonly applied for
patients when testing preoperatively
for monovision tolerance," said Dr.
Pallikaris and colleagues.
In the event that a patient can-
not adapt to presbyLASIK treatment,
the authors emphasized that having
an exit strategy is of utmost impor-
tance.
"Especially for the multifocal
approaches, a reversal of the effect
cannot be achieved easily and a
retreatment may be a compromise
between attempted refraction and
quality of vision," they said. EW
References
1. Pallikaris IG, et al. PresbyLASIK approach
for the correction of presbyopia. Curr Opin
Ophthalmol. 2015;26(4):265–272.
2. El Danasoury AM, et al. Multizone LASIK
with peripheral near zone for correction of
presbyopia in myopic and hyperopic eyes:
1-year results. J Refract Surg. 2009;25:296–
305.
Editors' note: Drs. Pallikaris, Ahmed,
and Dean have no financial interests
related to this article.
