Efficacy of Aspheric Corneal Ablation With the Central-Saving Technique for Presbyopic Correction Through Early Wound Healing Modulation

Abstract

Purpose: To assess the long-term efficacy, refractive changes, and final visual acuity results from emmetropic presbyopic corrections when using aspheric ablation with the central-saving technique (CST) through the modulation of early wound healing. Methods: This study was a prospective comparative study. Twenty-four eyes of 12 patients with emmetropia underwent aspheric corneal ablation while preserving the central cornea (CST group) by amniotic membrane patching to protect the center of the cornea and encourage early wound healing. Twenty-two eyes of 11 patients with emmetropia were treated with the conventional presbyopic excimer laser [non-central-saving technique (NCST) group]. The wound healing time, visual acuity, manifest refraction, and corneal topography before and 2 years after the surgery were compared across both groups. Results: The corneal wound healing time of the CST group was faster than that of the NCST group. The time it took to achieve effective near and distance visual acuities were 1.2 +/- 0.4 days and 2.3 +/- 1.5 days in the CST group, whereas the same took 2.3 +/- 1.2 days and 5.2 +/- 2.1 days each for the NCST group. Statistically significant differences in both distance and near visual acuity were observed between the CST and NCST groups 2 years after the operation. The mean refractive error showed less regression in the CST group than in the NCST group within this same time period. Conclusions: Laser corneal ablation with CST can be used effectively to treat patients with emmetropic presbyopia because it provides faster wound healing and longer lasting effective maintenance in near and far visual acuities.