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.