PURPOSE: To evaluate clinical outcomes and visual quality 12 months after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) performed with the Custom -Q algorithm for correction of myopia with or without astigmatism and compensate for age -related accommodation deficiency. METHODS: Patients who had Custom -Q FS-LASIK for myopia and myopic astigmatism with age -related accommodation deficiency were included in this retrospective study. Distance, intermediate, and near visual acuities, objective and subjec- tive refractions, Q -factor, corneal higher order aberrations (HOAs), accommodation function, defocus curve, contrast sensitivity, and a subjective questionnaire assessing visual quality were evaluated 12 months postoperatively. RESULTS: Clinical data of 43 cases were analyzed. The mean age was 42.02 +/- 1.85 years (range: 40 to 48 years). At the 12 -month follow-up visit, there were 43 (100%), 42 (97%), and 33 (77%) patients who achieved a binocular uncorrected distance, intermediate, and near visual acuity, respectively, better than 20/20 separately. Defocus curves revealed better distance vision in the dominant eyes, and the nondominant eyes performed better at intermediate and near vergence (P < .001). The Q -value and corneal spherical aberration coef- ficient were more positive in the dominant eyes than those in the nondominant eyes (P < .001). The accommodative am- plitude and relative accommodation improved binocularly (P < .001). The questionnaire demonstrated high patient satis- faction with near vision, and no one reported having severe visual disturbance. CONCLUSIONS: For myopic patients with age -related accom- modation deficiency, the Custom -Q algorithm proved to be an effective way to achieve acceptable near vision without com- promising distance vision.
