Advanced Surface Ablation for Presbyopia Using the Nidek EC-5000 Laser

PURPOSE: To present 1 to 6-month follow-up results of laser in situ keratomileusis (LASIK) using multizone presbyopic advanced surface ablation (PASA) with a peripheral near zone. METHODS: LASIK was performed on 28 eyes of 17 patients (10 men and 7 women; mean age 49.8 years with a range of 37 to 62 years). Eyes had primary or enhancement treatments with the Nidek EC-5000 excimer laser. Three techniques were used: 1) total transepithelial ablation, 2) surface ablation for far vision ametropia correction, and 3) concentric peripheral near zone presbyopia correction (technique developed by Dr. A. Telandro with a modified nomogram by Dr. R. Cantú for surface ablation). One surgeon (RC) performed all surgery. RESULTS: We present the preoperative and postoperative measurements for far and near uncorrected visual acuity, total high order aberrations, spherical aberration (Z-12), asphericity Q index, eccentricity corneal shape factor, and total coma and trefoil aberrations. Increases occurred in negative spherical aberration, negative asphericity index, and positive eccentricity corneal shape factor. CONCLUSIONS: Advanced surface ablation for presbyopia with a concentric peripheral near zone is a promising approach for surgical correction of presbyopia and potentially could be used with any advanced surface ablation procedure. Increases in negative spherical aberration and asphericity/ eccentricity indices seemed to increase the depth of focus of the eye, improving the near vision.