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Laser Thermal Keratoplasty in Patients with Hyperopia of Presbyopic Age

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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Laser Thermal Keratoplasty in Patients with Hyperopia of Presbyopic Age

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  1. 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

  2. Purpose – to assess the long-term efficacy and safety of LTK for hyperopia correction in patients of presbyopic age Methods Laser device«ОКО-1»(Russia) • infrared Ho:YAGlaser • wavelength : 2.12microns • Е: 130 – 180mJ • irradiation period – 0.5sec.

  3. Subjects Igroup IIgroup Accommodative amplitude: 0,75 - 1,5 D (mean 1,24±0,27 D) Accommodative amplitude: 1,75 - 2,75 D (mean 2,01±0,29 D) 27 patients (54 eyes) 25 patients (50 eyes) • Age: 43-61years • SE of refraction: 1,0-3,5 D • (mean 2,16±0,97 D ) • Age : 41-58 years • SE of refraction: 1,25-3,0 D • (mean 2,26±0,81 D ) Target refraction: low M Target refraction:Em

  4. Surgical procedure Schematic view of the operation Double-ring checkerboard pattern of 24 coagulation spots Laser energy: I group:Е160-180 mJ II group:Е130-150 mJ

  5. Results 1 day 3 days Stretch lines 6 months 3 years

  6. Dynamics of refraction

  7. Dynamics of uncorrected visual acuity Distance Near

  8. 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 +3.71±1.07 to +1.86±0.67

  9. Spectacle correction Post-op Post-op Igroup IIgroup For nearvision: 15% of patients For nearvision: 100% of patients Pre-op – glasses for near vision: 100% of the patients Presbyopic correctionsignificantly 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!

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

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