Hyperopia Correction by Optimal Keratoplasty

K. Jonathan Rodgers, MD
Contributing Authors: Harry Glen, MD and Michael Berry, PhD
Purpose: To evaluate the safety and effectiveness of the NTK Optimal Keratoplasty
(Opti-K) device and procedure for treating eyes with hyperopic presbyopia to achieve
distance and near visual acuity (UDVA and UNVA) improvement.
Methods: 65 eyes with hyperopic presbyopia (MRSE = +1.56 0.53 D; mean add: 2.03
0.51 D) of 35 patients (30 female, 5 male; mean age: 53.9 7.6 y) received primary
treatments (Txs) by the NTK Opti-K device (using laser thermal keratoplasty with a
sapphire applanation window for cornea epithelium protection) in order to achieve
UDVA/UNVA improvement. 52/23 eyes also received secondary/tertiary Txs. Initial
patients (n = 14) were treated using a monovision protocol; later patients were treated for
best UNVA improvement in both eyes. Follow-up (f/u) extends to 24m post-Tx.
Results: Safety no adverse events, loss of lines of corrected visual acuity (CDVA,
CNVA) or significant induced astigmatism have been observed. Epithelial protection and
comfort have been excellent. Effectiveness geometric mean (gm) UDVA improvement
was 4 lines at 1d post-Tx. Gm UDVA improvement decreased over time, regressing to
ca. 3 lines by 12m post-secondary Tx. Gm near visual acuity (UNVA) improved
significantly at almost all f/u times. Optimal keratoplasty has been achieved - corneas
have been reshaped to improve both UDVA and UNVA bilaterally. Successful patient
neuroadaptation to multifocality produced by optimal keratoplasty occurred
immediately post-Tx.
Conclusions: In eyes with hyperopic presbyopia, optimal keratoplasty (Opti-K)
appears to be safe and effective for improving UDVA/UNVA bilaterally. The procedure
is noninvasive, simple, rapid, comfortable and repeatable. VA improvement regresses
over time, but patients have elected to have further Opti-K Txs when needed to
maintain Vision Rejuvenation.