Multifocal ablations are option for correcting presbyopia

Multifocal ablations have been gaining ground for the correction of presbyopia in the past year. Here at the University of Ottawa we have been studying this approach with the VISX STAR S4 excimer laser, with promising results as many patients are able to achieve excellent near and distance acuity.

With VISX's patented ablation profile we create near acuity at the center of the cornea, with a steepened zone, and then target the periphery for distance. One of the major strengths of this approach is that it is less invasive than other proposed approaches for correcting presbyopia, such as scleral expansion bands, IOLs, and accommodating lenses. Here's a technique where you correct a refractive error as well as possibly higher-order aberrations and also leave the patient with some near vision.

For both distance and near vision, we found vision improved significantly after multifocal treatment. At the 3-month mark, 100% of patients (six eyes) attained 20/25 distance acuity or better. When it came to uncorrected near acuity, 100% were able to read J3 (20/40) or better, and 83% could see J1 (20/25) or better.

With this technique, at 3 months simultaneous uncorrected distance vision of 20/25 and near vision of J2 was achieved in all cases. So, all of these patients attained good distance vision of about 20/25 and were also able to read newspaper print. Out of that group we have a number of patients who do not wear any glasses whatsoever.