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Paloma Lopez, Julio C Hernandez, Jorge E Valdez; Refractive Surgery in the Elderly Population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4883.
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© ARVO (1962-2015); The Authors (2016-present)
Report on the safety, efficiency and results of refractive surgery in patients aged 65 or older.
Retrospective analysis of the records of elderly patients that underwent corneal refractive surgery during the period June 2010 to June 2015 at Hospital Zambrano Helion; Monterrey, Mexico. Refractive surgery was performed by one experienced surgeon using the Technolas 217z Excimer Laser (Bausch&Lomb, Rochester, NY, US). Inclusion criteria were patients ≥65 years old with preoperative manifest refraction spherical equivalent (MRSE) up to -8.5D, cylinder up to 6.0D, corrected distance visual acuity of 20/25 of better and central corneal thickness >500μm with no other ocular pathology.
A total of 44 eyes (24 patients) were included. Mean age was 67.2±3.1 (range 65 to 80), with a mean follow up of 6.2±1.3 months. Conventional LASIK was performed in 20 patients (Group 1, 36 eyes) to improve uncorrected distance visual acuity (10 eyes myopic LASIK, 26 eyes hyperopic LASIK) and presbyopic LASIK (monovision) in 4 patients (Group 2, 8 eyes) to restore near vision performance. Preoperative MRSE for the myopic eyes in group 1 was -2.79±1.88D and +2.19±1.88D for hyperopic eyes, MRSE for group 2 was +2.10±0.87D. Preoperative UDVA in group 1 was 0.67±0.30 LogMAR (20/100 Snellen) and 0.46±0.18 LogMAR (20/50 Snellen) and Jaeger ≥4 in 90% of the patients. Postoperative MRSE was -0.29±0.86D (myopic LASIK)(p<.001), -0.34±0.62D (hyperopic LASIK)(p<.001) and -1.25±0.59D (non-dominant eye) in presbyopic LASIK. Postoperative UDVA in myopic LASIK was 0.15±0.30 (20/25 Snellen)(p=.001) and 0.11±0.11 (20/25 Snellen)(p<.001) for hyperopic LASIK, with binocular UDVA 0.16±0.17 (20/25 Snellen)(p=0.12) and UNVA ≥J2 in 100% of the patients.
Even though elder patients may present greater LASIK restrictions due to lens evolution and other eye conditions related to older age, patients ≥ 65 years that were candidates showed satisfactory and safe results on both groups. 84% of the patients underwent conventional LASIK to correct myopia and hypermetropia to obtain better visual distance. The other 16% of the patients underwent monovision LASIK surgery to correct both near and far distances.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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