Presbyopia is an age-related eye condition where one of the signs is the reduction in the amplitude of accommodation, resulting in the loss of ability to change the eye's focus from far to near. It is the most common age-related ailments affecting everyone around their mid-40s. Methods for the correction of presbyopia include contact lens and spectacle options but the surgical correction of presbyopia still remains a significant challenge for refractive surgeons. Surgical strategies for dealing with presbyopia may be extraocular (corneal or scleral) or intraocular (removal and replacement of the crystalline lens or some type of treatment on the crystalline lens itself). There are however a number of limitations and considerations that have limited the widespread acceptance of surgical correction of presbyopia. Each surgical strategy presents its own unique set of advantages and disadvantages. For example, lens removal and replacement with an intraocular lens may not be preferable in a young patient with presbyopia without a refractive error. Similarly treatment on the crystalline lens may not be a suitable choice for a patient with early signs of cataract. This article is a review of the options available and those that are in development stages and are likely to be available in the near future for the surgical correction of presbyopia.

To analyze the incidence of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) performed with an IntraLase 15 kHz femtosecond laser (IntraLase, Corp.) or a Moria M2 mechanical microkeratome (Moria SA). Vissum Madrid, Madrid, Spain. This retrospective study compared the incidence of DLK in consecutive LASIK procedures performed with the IntraLase 15 kHz femtosecond laser (study group) or the Moria M2 microkeratome (control group). Two surgeons performed both types of surgeries (femtosecond laser and microkeratome) using the same excimer laser (Technolas 217, Bausch & Lomb). During the first week postoperatively, topical dexamethasone drops were applied 8 times daily in the femtosecond group and 4 times daily in the mechanical microkeratome group. A total of 2000 consecutive eyes were analyzed (1000 eyes in each group). Diffuse lamellar keratitis stage 2 developed in 1 patient in each group; DLK stage 3 developed in 4 patients in the study group and in no patient in the control group (P = .03). Despite more intense postoperative steroid treatment, DLK seemed to occur more frequently after LASIK performed with the IntraLase 15 kHz femtosecond laser than after LASIK performed with the Moria M2 microkeratome.

Purpose: To evaluate two different soft contact lens materials for continuous-wear bandage contact lenses after laser epithelial keratomileusis (LASEK). Methods: A prospective, observer-masked study was conducted of 32 eyes of 16 consecutive patients. Inclusion criteria were candidates for bilateral LASEK, myopia of ⩽−6.00 diopters (D), astigmatism <−1.50 D, and bilateral best spectacle-corrected visual acuity of 20/20 or better. Patients were randomly selected for a balafilcon A (PureVision; Bausch & Lomb) bandage contact lens in one eye and a poly-2-hydroxyethylmethacrylate-co-methacrylate glycerol (EquiS 60; mark'ennovy) in the fellow eye. Corneal epithelial status, conjunctival and limbal hyperemia, lens movement, contact lens debris, and the responses to a subjective comfort questionnaire were assessed postoperatively. The parameters were evaluated preoperatively and 1 and 5 days postoperatively. Paired Student t test and chi-square tests were used when appropriate. Results: Thirty-two eyes of 16 consecutive patients who underwent LASEK to correct low to moderate myopia were analyzed. The mean spherical equivalent refraction was −3.25 D. There was no difference in conjunctival or limbal hyperemia, contact lens debris, or subjective comfort between lenses at any postoperative visit. In contrast, the corneal epithelial status was statistically better in the eyes with a silicone bandage contact lens 5 days after LASEK ( P =.01). Conclusions: The results suggest that the bandage contact lens material used after LASEK affects the corneal epithelial healing process. [ J Refract Surg. 2008;24:199–203.]