Nonwavefront-guided Presby reversal treatment targeting a monofocal cornea after bi-aspheric ablation profile in a patient intolerant to multifocality.

PURPOSE: To analyze distance and near vision after a nonwavefront-guided Presby reversal treatment targeting a monofocal cornea in a patient intolerant to multifocality in the dominant eye.

METHODS: Case report.

RESULTS: An originally myopic patient treated for correcting distance ametropia and simultaneously alleviating presbyopic symptoms resulted in intolerance to the induced multifocality. Twenty-one months after the bi-aspheric multifocal treatment, the patient was treated with PresbyMAX reversal (SCHWIND eye-tech-solutions, Kleinostheim, Germany) to remove the previously induced multifocality. Original corrected distance visual acuity (CDVA) was -0.1 logMAR (20/16 Snellen) with +0.8 logMAR (J12) uncorrected near visual acuity (UNVA) and changed to CDVA +0.1 logMAR (20/25 Snellen) with +0.2 logMAR (J4) UNVA before the Presby reversal procedure (all monocularly). Three months after the reversal treatment, uncorrected distance visual acuity and CDVA were both -0.1 logMAR (20/16 Snellen), and the patient was emmetropic and had no further visual complaint for distance, but at the cost of losing the UNVA.

CONCLUSIONS: Nonwavefront-guided Presby reversal treatments targeting a monofocal cornea after bi-aspheric ablation profile were successful.