Multifocal Corneal Topographic Changes with Excimer Laser Photorefractive Keratectomy

Hamilton Moreira, Jenny J. Garbus, Armand Fasano, Martha Lee, Terrance N. Clapham, Peter J. McDonnell

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Excimer laser photorefractive keratectomy can flatten the central cornea, thereby eliminating myopic refractive errors; in older patients, however, presbyopia limits satisfaction. Computer-assisted topographic analysis of corneas after refractive surgery indicates that a minority of patients achieve a multifocal lens effect, such that they maintain reasonable acuity over a range of defocus. We have purposefully attempted to create a multifocal refractive effect and have analyzed the subsequent topographies quantitatively to determine if multifocality was achieved. In corneas not operated on and plastic hemispheres, a fairly small range of corneal powers is observed; the range of powers is increased after a monofocal ablation. After multifocal ablations, a greater spread of surface powers is observed, often with a bimodal distribution, indicative of an apparent multifocal effect. These observations suggest that in some patients undergoing photorefractive keratectomy for myopia, it may be possible to reduce symptoms of presbyopia, although a decrease in image contrast or monocular diplopia may complicate this approach.

Original languageEnglish (US)
Pages (from-to)994-999
Number of pages6
JournalArchives of ophthalmology
Issue number7
StatePublished - Jul 1992
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology


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