Pseudoaccommodation and visual acuity with Technovision presbyLASIK and a theoretical simulated Array multifocal intraocular lens.

PURPOSE: To compare the visual results of presbyLASIK patients to the best theoretical pseudoaccommodation that could be achieved using a multifocal refractive intraocular lens (IOL) model based on the optical structure of a simulated AMO Array multifocal IOL.

METHODS: The study included 10 hyperopic eyes that underwent central presbyLASIK surgery using a Technovision excimer laser platform. Mean patient age was 57 years, and mean preoperative spherical equivalent refraction was 1.28+/-0.87 diopters. The optical quality was evaluated by objective distance and near decimal visual acuities calculated using a Fresnel propagation algorithm based on a realistic eye model. Results of the presbyLASIK technique were compared with the theoretical results obtained for the same eye with an ideal, best-fit multifocal IOL (simulated Array multifocal IOL) substituted for the crystalline lens.

RESULTS: For near objective visual acuity (from 25 cm to 1 m), the ideal, theoretical Array-like lens provided values of visual acuity above 0.5 for all object distances, whereas presbyLASIK also provided good visual responses for distances beyond 45 cm. For distance vision (from 1.5 to 6 m), both the IOL and presbyLASIK visual acuities were over 0.5, but the optical performance of the ideal Array-like lens was slightly worse than with presbyLASIK.

CONCLUSIONS: Overall near to distance visual acuity obtained with the presbyLASIK technique is comparable to the best visual acuity that could be achieved with a simulated Array multifocal IOL. Near visual acuity with presbyLASIK falls off from the ideal.