PRESBIOPİYA ZAMANI AMETROPİYALARIN ASFERİK EKSİMER-LAZER KORREKSİYASININ EFFEKTİVLİYİ

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SUMMARY

Traditional excimer laser keratorefractive surgery is an effective and safe method of refraction anomalies
correction with a good prognosticated result. These surgeries are performed not only in young people, but
among those with presbyopia. With age the spherical aberration of the eye increases, but while removing the
spherocylindrical errors (of lower orders aberrations (LOA)) the excimer laser correction leads to the induction
of the high orders aberrations (HOA), mainly of spherical ones, that is manifested by the decrease of the retinal
image quality and the consequences of the development of certain optic problems and insufficient satisfaction of
the patients. The change of the physiological asphericity leads to the HOA induction, mainly, to spherical ones.
Proceeding from the mentioned above the new algorithm of the optimized excimer laser correction has been
worked out - aspheric ablation of the cornea.
The aim of the study is to learn the efficacy of the aspheric excimer laser correction of the different ametrops at
the presbyopy and the examination of spherical aberration before and after the operation as well. For the presbyopia
correction we used the “monovision” method. The investigation included 20 patients (39 eyes) with hyperopia and
hyperopic astigmatism, and 7 patients with myopia and myopic astigmatism at the age of 40-45. In conclusion the
patients with hyperopia were satisfied by correction because 65 % of such patients did not use the spectacles while
reading for a year, and 35 % of the patients used the spectacles for reading by + 0.5 D - +1.0D lower than their age
normal deviations. In two patients hyperopic regression was found and we repeated the intervention to strengthen
the refractive effect for 1 month. Some months later after the operation the miopic patients felt some discomfort
with their near vision, particularly in the evenings. In one case it was necessary to make an additional excimer
laser correction to remove the “monovision” effect. Despite it, 95% of the patients were satisfied by the result.
The decrease of the spherical aberrations postoperatively both in hiperopic and myopic groups was observed.
Application of the aspheric profile LASIK has ensured more qualified vision at the expense of the prevention of
HOA induction including the spherical aberrations that influenced the near vision very much. The “monovision”
method is a simple but quite effective one for the correction of presbyopia.