Laser Thermal Keratoplasty in Patients with Hyperopia of Presbyopic Age

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Laser Thermal Keratoplasty in Patients with
Hyperopia of Presbyopic Age

• Alexander V. Doga, MD, PhD, DSc,
• Alexander A. Shpak, MD, PhD, DSc,
• Irina A. Mushkova, MD, PhD,
• Suzy A. Antonian, MD

The S.N. Fyodorov Eye Microsurgery Federal State
Institution Moscow, Russian Federation
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Purpose to assess the long-term efficacy and
safety of LTK for hyperopia correction in
patients of presbyopic age
Methods

• Laser device ???-1 (Russia)
• infrared HoYAG laser
• wavelength 2.12 microns
• ? 130 180 mJ
• irradiation period 0.5 sec.

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Subjects
I group
II group
Accommodative amplitude 0,75 - 1,5 D (mean
1,240,27 D)
Accommodative amplitude 1,75 - 2,75 D (mean
2,010,29 D)
27 patients (54 eyes)
25 patients (50 eyes)

• Age 43-61years
• SE of refraction 1,0-3,5 D
• (mean 2,160,97 D )

• Age 41-58 years
• SE of refraction 1,25-3,0 D
• (mean 2,260,81 D )

Target refraction low M
Target refraction Em
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Surgical procedure
Schematic view of the operation
Double-ring checkerboard pattern of 24
coagulation spots
Laser energy I group ? 160-180 mJ II group ?
130-150 mJ
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Results
1 day
3 days
Stretch lines
6 months
3 years
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Dynamics of refraction
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Dynamics of uncorrected visual acuity
Distance
Near
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Results

• Group 1
• uncorrected distance VA did not change
  significantly
• uncorrected near VA improved by 5 lines
• Group 2
• uncorrected distance VA improved by 4 lines
• uncorrected near VA improved by 2 lines
• the presbyopic correction was reduced from
  3.711.07 to 1.860.67

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Spectacle correction
Post-op
Post-op
II group
I group
For near vision 15 of patients
For near vision 100 of patients
Pre-op glasses for near vision 100 of the
patients
Presbyopic correction significantly reduced !!
For far vision 26 of patients
For far vision 0 of patients
Pre-op glasses for far vision 87 of the
patients
No asthenopic symptoms in the two groups post-op!
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Conclusions

• Hyperopia correction in patients of presbyopic
  age by contact holmiumYAG LTK is safe and
  effective.
• Pre-op level of amplitude of accommodation
  provides important data for better planning of
  the operation in presbyopic patients.