journalofrefractivesurgery.com 494 Correction of Presbyopia in Hyperopia With a Center-distance, Paracentral-near Technique Using the Technolas 217z Platform Roberto Pinelli, MD; Dolores Ortiz, PhD; Anna Simonetto, MA; Cristian Bacchi, OD; Esperanza Sala, OD; Jorge L. Alió, MD, PhD From the Istituto Laser Microchirurgia Oculare, Brescia, Italy (Pinelli, Simonetto, Bacchi); the Research and Development Department, Vissum- Instituto Oftalmológico de Alicante, Alicante, Spain (Ortiz, Sala, Alió); and the Ophthalmology Department, Miguel Hernández University, Alicante, Spain (Alió). This study was supported in part by a grant of the Spanish Ministry of Health, Instituto Carlos III, Red Temática de Investigación en Oftalmologia, Subproyecto de Cirugia Refractiva y Calidad Visual (C03/13) and by a grant from the Spanish Generalitat Valenciana, ref: Grupos05/036 Grants and Support for scientific research and technological development in the Comunidad Valenciana for the year 2005. Dr Pinelli has a proprietary interest in the PML software. The remaining authors have no proprietary interest in the materials presented herein. Correspondence: Jorge L. Alió, MD, PhD, Research and Investigation Department, Instituto Oftalmológico Alicante, Vissum Corporation, Avda Denia s/n, Edificio Vissum, 03016 Alicante, Spain. Tel: 34 902 333 344; Fax: 34 965 160 468; E-mail: jlalio@vissum.com Received: September 13, 2006 Accepted: March 16, 2007 Posted online: October 31, 2007 ABSTRACT PURPOSE: To analyze the results of hyperopic patients treated with a peripheral presbyLASIK algorithm for the correction of presbyopia. METHODS: The study included 44 eyes of 22 hyper- opic patients treated with a peripheral presbyLASIK technique using a Technolas 217z excimer laser. Mean patient age was 56 years (range: 47 to 72 years), mean preoperative spherical equivalent refraction was +1.210.77 diopters (D) (range: +0.50 to +4.00 D), and mean spectacle near addition was +1.760.42 D (range: +1.00 to +2.75 D). The Peripheral Multi- focal LASIK (PML) ablation pattern creates a multifo- cal corneal profile over a 6.5-mm diameter, performing the distance correction first in a 6-mm optical zone and then near correction in a 6.5-mm zone. Main outcome measures were uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) for near and distance, spherical equivalent refraction, contrast sensitivity, and corneal aberrations. RESULTS: Six months postoperatively, mean binocular UCVA was 1.060.13 for distance and 0.840.14 for near. Mean postoperative spherical equivalent refraction was -0.42 D (range: -1.12 to +0.87 D). Two (4.5%) eyes lost 1 line of BSCVA for distance and near vision, and 20 (45%) eyes gained 1 line of distance BSCVA. Contrast sensitivity decreased for 3, 6, 12, and 18 cycles/degree. Corneal aberration analysis showed a slight increase in coma and decrease in spherical aberration. CONCLUSIONS: The peripheral presbyLASIK technique used in this study is a safe and efficient treatment that may improve functional near vision in presbyopic patients with low and moderate hyperopia (from +0.50 to +3.00 D). [J Refract Surg. 2008;24:494-500.] T he refractive correction of presbyopia is one of the most frequently discussed topics in refractive surgery today, generating curiosity and great interest through- out the world among surgeons and the ophthalmic in- dustry. There are several surgical approaches to the correction of presbyopia: conductive keratoplasty, presbyLASIK, monovi- sion correction, scleral expansion, and phakic and multifocal intraocular lens (IOL) implantation. Conductive keratoplasty is an effective and safe procedure for the treatment of presby- opia, 1 but it is limited by its monocular application. Mono- vision correction (by corneal refractive surgery or refractive lens exchange), is a surgical strategy for those patients who need distance and near vision with realistic expectations, but it has some disadvantages, such as the decrease in contrast sensitivity. 2 Accurate patient selection is also crucial for this strategy because monovision is not well tolerated by all pa- tients. Scleral expansion is another surgical approach to cor- rect presbyopic symptoms but is prone to regression. 3 The performance of different types of IOLs (refractive, diffractive, pseudoaccommodating, and multifocal) is constantly being improved, 4,5 but the IOLs cause a decrease in near vision con- trast sensitivity. 6