Vol. 5 (2021): International Journal of Case Reports
Case Reports


Tjahjono D. Gondhowiardjo, MD, PhD1,2
1Dept. of Ophthalmology, Faculty of Medicine, University of Indonesia – Cipto Mangunkusumo “Kirana” Hospital, Jakarta, Indonesia. 2JEC Hospitals and Clinics, Jakarta, Indonesia.


  • Eyeballs; Lasik surgery; Neuro sensory parts; supporting tissue; topographic indicators; visual acuity

How to Cite

Tjahjono D. Gondhowiardjo, MD, PhD1,2. (2021). BEYOND PSEUDO-ACCOMODATIVE CORNEA LASIK (PAC LASIK). A PERSONAL INSIGHT. International Journal of Case Reports, 5, 200. https://doi.org/10.28933/ijcr-2021-01-3005


Laser in-situ keratomieleusis (LASIK) is a common intervention for young, active, ametropic individuals to improve their visual acuity. pseudo-accommodative cornea (PAC), a variant of LASIK, to correct ametropia among presbyopic patients is proven in maintaining good distant vision; yet, the satisfactory spectacle free reading vision is limited to the ageing progression.
However, successful treatments do not guarantee patient’s satisfaction. Assesment of the objective topographic indicators, visual acuity, higher order abrasion, and contrast sensitivity; revealed the clarification of a mild headache as a personal subjective experience after the treatment.
The role of the persistent, dominant eye, the brain perception, seems to be critical factor to a patient’s satisfaction. To a certain degree, the interplay amongst the optical part and it’s supporting tissue, within and between the eyeballs, as well as its relationship to the neurosensory parts of the visual systems after Lasik surgery have not yet been assessed and reported elsewhere.


  1. Klokova OA, Sakhnov SN, Geydenrikh MS, et al. Quality of life after refractive surgery: ReLex SMILE vs Femto-LASIK. Clin Ophthalmol 2019; 13:561-570.
  2. Plainis S, Charman WN, Pallikaris IG. The physi-ologic mechanism of accommodation. April 2014. Available at: https://crstodayeurope.com/articles/2014-apr/the-physiologic-mechanism-of accommodation/. Accessed March 21, 2020.
  3. Telandro A. Pseudo-accommodative cornea: a new concept for correction of presbyopia. J Re-fract Surg 2004;20(5 Suppl):S714-717.
  4. Telandro A. The pseudoaccommodative cornea multifocal ablation with a center-distance pattern: a review. J Refract Surg 2009;25(1 Suppl):S156-159.
  5. Uy E, Go R. Pseudoaccommodative cornea treatment using the NIDEK EC-5000 CXIII excimer laser in myopic and hyperopic presbyopes. J Refract Surg 2009;25(1 Suppl):S148-155.
  6. Rowsey JJ, Fouraker BD. Cornea Coupling Prin-ciple. Int Ophthalmol Clinics 1996;36:29-38.
  7. Nidek Co., LTD. OPD-Scan II ARK-10000 Optical Path Different Scanning System. 2006. Available at: http://www.nidek.fr/media/catalogue/MOP0003/OPD_SCANII.pdf. Accessed March 24, 2020.
  8. Guirao A, Williams DR. A method to predict re-fractive errors from wave aberration data. Optom Vis Sci 2003;80:36-42.
  9. Kaiserman I, Hazarbassanov R, Varssano D, et al. Contrast sensitivity after wave front-guided LASIK. Ophthalmology 2004;111:454-457.
  10. Villegas EA, AlcÓn E, Artal P. Optical Quality of the Eye in Subjects with Normal and Excellent Visual Acuity. Invest Ophthalmol Vis Sci 2008;49:4688-4696.
  11. Hwang AD, Peli E. Positive and negative polarity contrast sensitivity measuring app. IS&T Int Symp Electron Imaging 2016;2016:10.2352/ ISSN.2470- 1173.2016.16.HVEI-122.
  12. Suttle C, Alexander J, Liu M, et al. Sensory ocu lar dominance based on resolution acuity, contrast sensitivity and alignment sensi-tivity. Clin Exp Optom 2009;92:1:2-8.
  13. Lopes-Ferreira D, Neves H, Queiros A, et al. Oc-ular Dominance and Visual Function Testing. Biomed Res Int 2013;2013:238943.
  14. Li J, Lam CS, Yu M, et al. Quantifying sensory eye dominance in the normal visual system: a new technique and insights into variation across tradi-tional tests. Invest Ophthalmol Vis Sci 2010;51(12):6875-6881.