Defocus Curve and Satisfaction of Patients with Presbyopia After LASIK Using the Differential Modulation of Binocular Longitudinal Spherical Aberration

Abstract

Purpose

To investigate the visual acuity and satisfaction of patients after Zhang & Zheng’s corneal laser-enhanced accommodation refraction Q (ZZ-CLEAR-Q) surgery utilizing differential modulation of binocular longitudinal spherical aberration and determine its clinical significance.

Patients and Methods

This prospective observational study enrolled a consecutive cohort of patients with presbyopia who underwent ZZ-CLEAR-Q surgery between December 2020 and January 2023. The study assessed visual acuity, distance-corrected defocus curve, satisfaction, Q factor, manifest spherical equivalent, and primary spherical aberration, among others, at 3 months postoperatively. Additionally, the study conducted a binocular comparison to analyze the clinical significance of setting the different longitudinal spherical aberrations.

Results

A total of 232 eyes of 116 patients were included. The binocular uncorrected distance visual acuity was 20/20 for all patients. At 3 months postoperatively, the binocular uncorrected near visual acuity was Jaeger 1 for 96% of the patients and Jaeger 2 for 100% of the patients. Furthermore, 93.1% of the patients expressed satisfaction. The monocular distance-corrected defocus curve revealed that the dominant eyes had significantly better visual acuity at 0 D (P<0.001), while the non-dominant eyes had significantly better visual acuity across various defocus levels except 0 and −0.50 D (All P<0.05). At 3 months, there were no significant differences between the expected and achieved manifest spherical equivalents, corneal Q factor values, and ocular primary spherical aberration values of both groups.

Conclusion

Patients with presbyopia who underwent ZZ-CLEAR-Q surgery were likely to achieve normal uncorrected visual acuity and be satisfied. The increased depth of field has clinical significance for assisting near vision.

Keywords:

• defocus curve
• LASIK
• presbyopia
• Q factor
• spherical aberration

Data Sharing Statement

The data supporting the findings of this study are available from the corresponding author upon reasonable request.

Ethics Approval and Informed Consent

This study received ethical approval from the Medical Research Ethics Committee of Hangzhou MSK Eye Hospital (#MSKLL201215) and was conducted in accordance with the principles outlined in the Declaration of Helsinki. Prior to participating in the study, all participants were provided with detailed information regarding the potential risks and benefits of the procedure. Written informed consent was obtained from each participant, indicating their voluntary agreement to participate in the study. Adherence to ethical guidelines ensured the protection of participants’ rights and welfare throughout the research process.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study received support from the Zhejiang Medical and Health Science and Technology Project, specifically grant numbers 2018267858 and 2020167858. It is important to note that the funders had no involvement in the design of the study, collection and analysis of data, decision to publish, or preparation of the manuscript. The funding was provided solely to support the research and its findings.