Der Ophthalmologe

, Volume 103, Issue 8, pp 667–672 | Cite as

PresbyLASIK

Behandlungsansätze mit dem Excimerlaser

Zusammenfassung

Die Presbyopie stellt die häufigste Form einer Fehlsichtigkeit dar. Trotz aller Weiterentwicklungen in der Ophthalmologie gibt es zurzeit noch kein chirurgisches Verfahren, welches die Presbyopie effektiv, reliabel und sicher behandeln kann.

Der Einsatz der Excimerlaserchirurgie zur Behandlung von Fehlsichtigkeiten wie der Myopie, Hyperopie und des Astimatismus sind schon seit einigen Jahren in die klinische Routine eingegangen. Für die Behandlung der Altersweitsichtigkeit werden gegenwärtig verschiedene Therapieoptionen mit dem Excimerlaser entwickelt. Neben der Schaffung einer Monovision stellt die Formung einer multifokalen Hornhaut einen weiteren Behandlungsansatz dar. Diese Verfahren wird auch als „PresbyLASIK“ bezeichnet. Es werden hier die verschiedenen Ablationsprofile zur Erzielung einer multifokalen Hornhaut erläutert und erste klinische Erfahrungen aus der Literatur vorgestellt.

Zusammenfassend stellt die „PresbyLASIK“ einen neuen, interessanten Behandlungsansatz dar, der möglicherweise noch ein großes Entwicklungspotenzial besitzt.

Schlüsselwörter

PresbyLASIK Multifokale Hornhaut Presbyopie Excimerlaser 

PresbyLASIK

Treatment approaches with the excimer laser

Abstract

Presbyopia represents the most common refractive error. There is currently no surgical treatment for presbyopia, which is effective, reliable, and safe.

Excimer laser surgery has become a routine procedure for the correction of myopia, hyperopia, and astigmatism for years. Various treatment strategies for presbyopia have been brought forward using the excimer lasers. Besides monovision, creation of a multifocal cornea represents an attractive option. This procedure is also called “PresbyLASIK.” Different ablation profiles to form a multifocal cornea are reviewed here and first clinical results are summarized.

“PresbyLASIK” is a new, interesting treatment strategy, with a huge potential for the future. At the present it should be used in controlled studies only because of some unsolved questions.

Keywords

PresbyLASIK Multifocal cornea Presbyopia Excimer laser 

Literatur

  1. 1.
    Alio JL, Chaubard JJ, Caliz A et al. (2006) Correction of Presbyopia by Technosvision central multifocal LASIK (PresbyLASIK). J Refract Surg 22(5): 453–460PubMedGoogle Scholar
  2. 2.
    Anschutz T (1994) Laser correction of hyperopia and presbyopia. Int Ophthalmol Clin 34: 105–135Google Scholar
  3. 3.
    Barraquer JI (1996) The history and evolution of keratomileusis. Int Ophthalmol Clin 36(4): 1–7Google Scholar
  4. 4.
    Bauerberg M (1999) Centered vs off centered ablation to correct hyperopia and presbyopia. J Refract Surg 15: 66–69PubMedGoogle Scholar
  5. 5.
    Bito LZ, Miranda OC (1989) Accommodation and presbyopia. In: Reinecke RD (ed) Ophthalmology annual. Raven, New York, pp 103–128Google Scholar
  6. 6.
    Buratto L, Ferrari M, Genisi C (1993) Myopic keratomileusis with the eximer laser: one-year follow up. Refract Corneal Surg 9: 12–19PubMedGoogle Scholar
  7. 7.
    Campbell FW (1957) The depth of field of the human eye. Opt Acta (Lond) 4(4): 157–164Google Scholar
  8. 8.
    Campbell FW, Gubisch RW (1966) Optical quality of the human eye. J Physiol 186(3): 558–578PubMedGoogle Scholar
  9. 9.
    Cantu R, Marco AR, Tepichin E et al. (2004) Advanced surface ablation for presbyopia using the Nidek EC-5000 laser. J Refract Surg 20: 711–713Google Scholar
  10. 10.
    Coleman DJ (1986) On the hydraulic suspension theory of accommodation. Trans Am Ophthalmol Soc 84: 846–868PubMedGoogle Scholar
  11. 11.
    Croft M, Glasser A, McDonald J et al. (2005) Age-related loss of ciliary body forward movement in the rhesus monkey. Invest Ophthalmol Vis Sci, ARVO abstract 713Google Scholar
  12. 12.
    Duane A (1922) Studies in monocular and binocular accommodation with their clinical applications. Am J Ophthalmol 5: 867–877Google Scholar
  13. 13.
    Duke-Elder S (1970) System of ophthalmology. In: Duke-Elder S (ed) Ophthalmic optic and refraction, Vol 5. Henry Kompton, London, pp 274–295Google Scholar
  14. 14.
    Durnevv VV (1981) Characteristics of surgical correction of myopia after 16 and 32 peripheral anterior radial non-perforating incisions. In: Fyodorov SN (ed) Surgery of anomalies in ocular refraction. The Moscow Research Institute of Ocular microsurgery, Moscow, pp 33–35Google Scholar
  15. 15.
    Erickson P, McGill EC (1992) Role of visual acuity, stereoacuity and ocular dominance in monovision patient success. Optom Vis Sci 69: 761–764PubMedGoogle Scholar
  16. 16.
    Fleming J (1993) Corneal asphericity and visual function after radial keratotomy. Cornea 12: 233–240PubMedGoogle Scholar
  17. 17.
    Fonda G (1966) Presbyopia corrected with single vision spectacles or corneal lenses in preference to bifocal corneal lenses. Trans Am Opthalmol Soc 25: 78–80Google Scholar
  18. 18.
    Glasser A (2006) Restoration of accommodation. Curr Opin Ophthalmol 17: 12–18CrossRefPubMedGoogle Scholar
  19. 19.
    Glasser A, Campbell MCW (1998) Presbyopia and the optical changes in the human crystalline lens with age. Vision Res 38(2): 209–229CrossRefPubMedGoogle Scholar
  20. 20.
    Glasser A, Campbell MCW (1999) Biometric, optical and physical changes in the isolated human crystalline lens with age in relation to presbyopia. Vis Res 39: 1991–2015CrossRefPubMedGoogle Scholar
  21. 21.
    Hemenger RP, Tomlinson A, McDonnell PJ (1990) Explanation for good visual acuity in uncorrected hyperopia and presbyopia after radial keratotomy. Invest Ophthalmol Vis Sci 8: 1644–1646Google Scholar
  22. 22.
    Jain S, Aurora I, Azar DT (1996) Success of monovision in presbyopes: review of literature and potential applications to refractive surgery. Surv Ophthalmol 40: 491–499CrossRefPubMedGoogle Scholar
  23. 23.
    Josephson JE, Caffery BE (1988) Monovision versus aspheric bifocal contact lenses: a crossover study. J Am Optom Assoc 59: 491–495PubMedGoogle Scholar
  24. 24.
    Krueger RR, Juhasz T, Gualano A, Marchi V (1998) The picosecond laser for nonmechanical laser in situ keratomileusis. J Refract Surg 14(4): 467–469PubMedGoogle Scholar
  25. 25.
    Krueger RR, Kuszak J, Lubatschowski H et al. (2005) First safety study of femtosecond laser photodisruption in animal lenses: tissue morphology and cataractogenesis. J Cataract Refract Surg 31(12): 2386–2394CrossRefPubMedGoogle Scholar
  26. 26.
    Maguire LJ, Bourne WM (1989) A multifocal lens effect as a complication of radial keratotomy. Refract Corneal Surg 6: 394–399Google Scholar
  27. 27.
    McDonnell PJ, Garbus J, Lopez PF (1988) Topographic analysis and visual acuity after radial keratotomy. Am J Ophthalmol 106: 692–695PubMedGoogle Scholar
  28. 28.
    McDonnell PJ, Nizam A, Lynn MJ, Waring GO, The PERK Study Group (1996) Morning-to-evening change in refraction, corneal curvature, and visual acuity 11 years after radial keratotomy in the prospective evaluation of radial keratotomy study. Ophthalmology 103(2): 233–239PubMedGoogle Scholar
  29. 29.
    Miranda D, Krueger RR (2004) Monovision laser in situ keratomileusis for pre-presbyopic and presbyopic patients. J Refract Surg 20: 325–328PubMedGoogle Scholar
  30. 30.
    Moreira H, Garbus JJ, Fassano A et al. (1992) Multifocal corneal topographic changes with excimer laser photorefractive keratectomy. Arch Ophthalmol 110: 994–999PubMedGoogle Scholar
  31. 31.
    Munnerlyn CR, Koons SJ, Marshall J (1988) Photorefractive keratectomy: a technique for laser refractive surgery. J Cataract Refract Surg 14(1): 46–52PubMedGoogle Scholar
  32. 32.
    Ostrin LA, Glasser A (2004) Accommodation measurements in a prepresbyopic and presbyopic population. J Cataract Refract Surg 30: 1435–1444CrossRefPubMedGoogle Scholar
  33. 33.
    Ostrin LA, Kasthurirangan S, Glasser A (2004) Evaluation of a satisfied bilateral scleral expansion band patient. J Cataract Refract Surg 30: 1445–1453CrossRefPubMedGoogle Scholar
  34. 34.
    Pallikaris IG, Papatzanaki ME, Stathi EZ et al. (1990) Laser in situ keratomileusis. Lasers Surg Med 10: 163–168Google Scholar
  35. 35.
    Pallikaris IG, Papatzanaki ME, Siganos DS, Tsilimbaris MK (1991) A corneal flap technique for laser in situ keratomileusis. Human studies. Arch Ophthalmol 109(12): 1699–1702PubMedGoogle Scholar
  36. 36.
    Pierscionek BK, Popiolek-Masajada A, Kasprzak H (2001) Corneal shape change during accommodation. Eye 15: 766–769PubMedGoogle Scholar
  37. 37.
    Poyer JF, Kaufman PL, Flübel C (1993) Age does not affect contractile response of the isolated monkey ciliary muscle to muscarinic agonists. Curr Eye Res 12: 413–422PubMedGoogle Scholar
  38. 38.
    Saitoh K, Yoshida K, Hamaatsu Y et al. (2004) Changes in the shape of the anterior and posterior corneal surfaces caused by mydriasis and miosis. J Cataract Refract Surg 30: 1024–1030CrossRefPubMedGoogle Scholar
  39. 39.
    Sato T (1942) Crosswise incisions of Descemet’s membrane for the treatment of advanced keratoconus. Acta Soc Ophthalmol 46: 469–470Google Scholar
  40. 40.
    Savage HI (2003) Slight astigmatism may not be bad for presbyopes. Eye World 12: 30Google Scholar
  41. 41.
    Schiötz HA (1885) Ein Fall von hochgradigem Hornhautastigmatismus nach Starextraction: Besserung auf operativem Wege. Arch Augenheilkd 15: 179–181Google Scholar
  42. 42.
    Tamm E, Croft MA, Jungkunz W et al. (1992) Age-related loss of ciliary muscle mobility in the rhesus monkey: role of the choroid. Arch Ophthalmol 110: 871–876PubMedGoogle Scholar
  43. 43.
    Trokel SL, Srinivasan R, Braren B (1983) Excimer laser surgery of the cornea. Am J Ophthalmol 96(6): 710–715PubMedGoogle Scholar
  44. 44.
    Telandro A (2004) Pseudo-accommodative cornea: A new concept for correction of presbyopia. J Refract Surg 20: S714–717PubMedGoogle Scholar
  45. 45.
    Telandro AP, Steile J 3rd (2006) Presbyopia: perspective on the reality of pseudoaccommodation with LASIK. Ophthalmol Clin North Am 19: 45–69PubMedGoogle Scholar
  46. 46.
    Vinciguerra P, Nizzola GM, Nizzola F et al. (1998) Zonal photorefractive keratectomy for presbyopia. J Refract Surg 14: 8218–8221Google Scholar
  47. 47.
    Wood JM, Wick K, Shuley V et al. (1998) The effect of monovision contact lens wear on driving performance. Clin Exp Optom 81(3): 100–103PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Universitäts-Augenklinik BonnBonn

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