Clinical Ophthalmology (Nov 2023)
Defocus Curve and Satisfaction of Patients with Presbyopia After LASIK Using the Differential Modulation of Binocular Longitudinal Spherical Aberration
Abstract
Jun Zhang, Jie Shao, Xinfang Cao, Yonggang Zhang, Li Zheng Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, People’s Republic of ChinaCorrespondence: Jun Zhang, Hangzhou MSK Eye Hospital, No. 384, Fengqi Road, Gongshu District, Hangzhou, Zhejiang, People’s Republic of China, Tel +86 18667046602, Fax +86 85068587, Email [email protected]: To investigate the visual acuity and satisfaction of patients after Zhang & Zheng’s corneal laser-enhanced accommodation refraction Q (ZZ-CLEAR-Q) surgery utilizing differential modulation of binocular longitudinal spherical aberration and determine its clinical significance.Patients and Methods: This prospective observational study enrolled a consecutive cohort of patients with presbyopia who underwent ZZ-CLEAR-Q surgery between December 2020 and January 2023. The study assessed visual acuity, distance-corrected defocus curve, satisfaction, Q factor, manifest spherical equivalent, and primary spherical aberration, among others, at 3 months postoperatively. Additionally, the study conducted a binocular comparison to analyze the clinical significance of setting the different longitudinal spherical aberrations.Results: A total of 232 eyes of 116 patients were included. The binocular uncorrected distance visual acuity was 20/20 for all patients. At 3 months postoperatively, the binocular uncorrected near visual acuity was Jaeger 1 for 96% of the patients and Jaeger 2 for 100% of the patients. Furthermore, 93.1% of the patients expressed satisfaction. The monocular distance-corrected defocus curve revealed that the dominant eyes had significantly better visual acuity at 0 D (P< 0.001), while the non-dominant eyes had significantly better visual acuity across various defocus levels except 0 and − 0.50 D (All P< 0.05). At 3 months, there were no significant differences between the expected and achieved manifest spherical equivalents, corneal Q factor values, and ocular primary spherical aberration values of both groups.Conclusion: Patients with presbyopia who underwent ZZ-CLEAR-Q surgery were likely to achieve normal uncorrected visual acuity and be satisfied. The increased depth of field has clinical significance for assisting near vision.Keywords: defocus curve, LASIK, presbyopia, Q factor, spherical aberration
