多焦点激光原位屈光性角膜磨镶术治疗老视

An Initial Observation of Multifocal LASIK to Correct Presbyopia

目的:观察多焦点激光原位屈光性角膜磨镶术(多焦点LASIK)治疗老视眼的疗效和安全性。方法:将2004年10月起于我院屈光手术中心行多焦点LASIK的老视患者分为近视组和远视组,近视组包括近视合并老视患者10例20眼,术前屈光度等值球镜为-1.75--7.75(-4.9±2.3)D,近调节附加为+1.5-+2.75(+2.1±0.4)D,远视力为0.1-0.2(0.1±0.1),近视力为0.1-1.0(0.4±0.3)。远视组包括远视合并老视患者6例12眼,术前屈光度等值球镜为+1.25-+3.25(+2.1±0.8)D,近调节附加为+2-+2.5(+2.3±0.3)D,远视力为0.3-0.7(0.4±0.1),近视力为0.1-0.3(0.1±0.1)。所有眼均行多焦点LASIK手术,使用的设备为尼德克EC-5000CXⅡ准分子激光系统,并使用模拟调节角膜(PAC)软件计算激光切削形态。结果:术后6-12个月复查,近视组术后屈光度等值球镜为-2.5--0.5(-1.0±0.7)D,远视力为0.3-1.2(0.8±0.3),近视力为0.4-1.0(0.8±0.2)。远视组术后屈光度等值球镜为-1.25-+0.5(-0.7±0.7)D,远视力为0.6-1.0(0.8±0.2),近视力为0.3-0.8(0.6±0.2),1眼损失1行最佳矫正视力。结论:使用尼德克EC-5000CXⅡ准分子激光系统和PAC软件施行多焦点LASIK手术是一种安全、有效的矫正老视的手术方法。

Objective： To observe efficacy and safety of multifocal LASIK for the correction of presbyopia. Methods： The myopia group included 20 eyes of 10 patients and hyperopia group included 12 eyes of 6 patients. Muhifocal LASIK was performed on all eyes using a Nidek EC-5000 CX Ⅱ excimer laser. Pseudo-accommodative cornea （PAC） software was used to calculate the multistep ablation profile. Baseline mean spherical equivalent refraction, near addition, unaided distant visual acuity and unaided near visual acuity was measured and compared before and after LASIK. Results： Six to twelve months after surgery, in the myopia group, postoperative mean spherical equivalent refraction was -2.5-0.5（-1.0±0. 7）D, unaided distant visual acuity was 0. 3-1.2 （0.8±0.3）, unaided near visual acuity was 0. 4-1. 0（0. 8±0. 2）. In the hyperopia group, postoperative mean spherical equivalent refraction was -1.25＋0.5 （-0.7±0.7） D, unaided distant visual acuity was 0.6-1.0 （0.8±0.2）, unaided near visual acuity was 0.3-0.8 （0.6±0.2）, and only one eye lost one line of BSCVA. Conclusion： Multifocal LASIK for presbyopia using the Nidek EC-5000 CX Ⅱ excimer laser and PAC software was safe and effective.