Custom-Q Presbyopic LASIK

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1 Custom-Q Presbyopic LASIK Dr. Arthur Cheng Consultant Ophthalmologist, Hong Kong Sanatorium & Hospital Honorary Clinical Associate Professor, The Chinese University of Hong Kong Hong Kong Sanatorium & Hospital

2 Q - Asphericity f 1 f 2 f 3 ΔD = 0 Positive Q value

3 Q - Asphericity f 1 f 2 f 3 ΔD Ideal asphericity Q = -0.46

4 +ve SA +ve Q -ve SA -ve Q

5 Treatment planning 5

6 Custom-Q - Presby LASIK Study 32 consecutive eyes of 16 presybopic patients All required at least 0.5 D of near addition to see J1 Custom-Q LASIK (F-Cat, Allegretto, ALCON Inc., Forth Worth, TX, USA) Target Q-value of -1 Follow up 6 months 6

7 Methods Mean age was years MRSE of D (range -8.38D to -2.5D) Average near add D (range 0.5 D to 1.25 D). Mean postoperative MRSE at 1 month, 3 months and 6 months were D, D, D respectively 7

8 Visual Outcomes Hong Kong Sanatorium & Hospital

9 Change in BSCVA - Safety 9

10 10

11 11

12 12

13 With distance correction only, all patients achieved J1 at near during all follow-up visits 13

14 Objective Assessments Hong Kong Sanatorium & Hospital

15 Wavefront Multifocality Assessment 15

16 Wavefront Multifocality Assessment The mean achieved multifocality was 0.68D 0.13D (range 0.32D to 0.94D) across the pupil from 3mm to 6mm pupil 16

17 Effect on Corneal Spherical Aberrations 17

18 Change of corneal curvature from apex outwards Hong Kong Sanatorium & Hospital 18

19 Clinical Case Treatment Results Corneal topography pre- and post-op Pre-op Post-op Difference

20 Contrast Sensitivity 20

21 Subjective Assessments Hong Kong Sanatorium & Hospital

22 Subjective Score 94.4% spectacle independence 100% found it more convenient than before surgery 100% would recommend the surgery to their friends Overall satisfaction rate was at 1 month improved to at 6 months 22

23 Halos improved from to Glare improved from to Haze improved from to

24 Summary we have demonstrated that Custom-Q presbyopic LASIK can safely and effectively treat early presbyopia up to 1.25 D 24

25 Patient selection Who are the best patients - Large scotopic pupil and small photopic pupil (7mm > 4mm) - MRSE < -5D - Early presbyope ( limited by the max target Q), high presbyope need modified monovision 25

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32 Thankyou! 32

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