Eyeworld

51 EW REFRACTIVE February 2018 is a wavefront-guided treatment that has several mechanisms to increase near vision, while maintaining good distance vision as well, that include micro-monovision, depth of field, spherical aberration, vertex centra- tion, retinal image processing, neu- ral summation, blur adaptation, and neural suppression," Dr. Falcon said. "A patient's spherical aberration can increase the circle of least confusion, improving the depth of field." Image integration in the brain in vital to refractive corrections that are set at different distances. In an unrelated study, investigators demonstrated the effect of image merging by the brain to see near and far without glasses. The study's hyperopic monovision protocol was well tolerated by 97% of the study patients that included 258 eyes of 129 consecutive patients with mod- erate to high hyperopia, hyperopic astigmatism and presbyopia, with corrections up to +5.75 D. Contrast sensitivity was improved, and the distance vision of near eyes was found to contribute positively to binocular distance vision compared to distance eyes monocularly. 1 "Laser blended vision for presbyopia has a high percentage of satisfaction for emmetropic, myopic, hyperopic, and astigmatic patients with a fast adaptation and good outcomes in visual acuity for distance and near," Dr. Falcon said. "The results are as good for younger patients with presbyopia as for older ones. Though they become adapted, patients more than 50 years of age are likely to perceive the difference of vision between the eyes more acutely. Still, patient satisfaction is not always related to visual acuity, as image processing is important to give comfortable vision. The higher percentage of enhancements and higher patient expectations com- pared to standard LASIK could influ- ence patient satisfaction as well. But we have to remember that achieving all patient expectations is not always possible." EW Reference 1. Reinstein DZ, et al. LASIK for hyperopic astigmatism and presbyopia using micro- monovision with the Carl Zeiss Meditec MEL80 platform. J Refract Surg. 2009;25: 37–58. Editors' note: Dr. Falcon has no finan- cial interests related to his comments. Contact information Falcon: drcristianfalcon@gmail.com We wrote the book on eye disease. When the world looks for the latest innovations in ophthalmic diagnosis and treatment, it looks to Wills Eye. Our expertise and thought leadership defined the field in 1832 and continue to redefine it today. 840 Walnut Street Philadelphia, PA 19107 willseye.org 877-289-4557

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