Objective Quality of Vision in Presbyopic and Non-presbyopic Patients After Pseudoaccommodative Advanced Surface Ablation

Abstract

PURPOSE: To analyze the objective quality of vision at 6 months postoperatively after pseudoaccommodative (presbyopic) advanced surface ablation (PASA). METHODS: The study comprised 62 eyes of 35 patients with 6-month follow-up that underwent primary or secondary treatments using PASA. Pre- and postoperative results of distance and near uncorrected visual acuity (UCVA), spherical aberration (coefficient of the Z12 Zernike polynomial), and the asphericity (Q) index were reviewed. The corresponding wavefront maps (total, low, and high order aberrations) and the corresponding point spread function and modulation transfer function (MTF) were also calculated. RESULTS: Our results show that PASA improves distance and near mean UCVA, increases negative spherical aberration and negative asphericity index, and improves the corresponding MTF. CONCLUSIONS: Pseudoaccommodative advanced surface ablation is a promising approach for the surgical correction of presbyopia with distance refractive error (myopia and hyperopia with or without astigmatism). This PASA technique could theoretically be used in non-presbyopic patients with refractive error or post cataract patients with monofocal intraocular lenses. The increase in negative spherical aberration and asphericity/eccentricity index seems to increase the depth of focus of the eye, improving the near vision and compensating the age-related lens changes. Rather than creating a multifocal cornea, PASA appears to create an improved aspheric (prolate) ablation profile.