不对称多焦点激光原位屈光性角膜磨镶术治疗近视合并老视的效果

Outcomes of Asymmetric Multifocal LASIK for Myopic Patients with Presbyopia

目的:观察不对称多焦点激光原位屈光性角膜磨镶术(LASIK)治疗近视合并老视的有效性和安全性。方法:前瞻性非随机临床研究近视合并老视患者22例(44眼),平均年龄51岁。主视眼术前屈光度等值球镜为-(7.25±2.18)D,非主视眼术前屈光度等值球镜为-(7.22±2.12)D。对所有患者施行双眼不对称矫正的多焦点LASIK术,主视眼预矫正目标为-0.25 D,非主视眼预矫正目标为-0.75 D。使用的设备为尼德克EC-5000CXⅡ准分子激光系统。结果:手术6个月后,主视眼屈光度等值球镜为-(0.61±0.47)D,82%的术眼裸眼远视力达到0.8或以上,41%的术眼裸眼近视力达到0.8或以上。非主视眼屈光度等值球镜为-(1.05±0.45)D,41%的术眼裸眼远视力达到0.8或以上,73%的术眼裸眼近视力达到0.8或以上。术后100%的患者双眼裸眼远视力达到0.8或以上,77%的患者双眼裸眼近视力达到0.8或以上。所有眼均未丧失1行以上的最佳矫正视力,术中及术后无严重并发症。结论:不对称多焦点LASIK术是一种安全、有效的矫正近视合并老视的手术方法。

Objective： To evaluate the outcomes of asymmetric multifocal LASIK for myopic patients with presbyopia.Methods： Twenty-two myopic patients with presbyopia（44 eyes） were included in this prospective non-comparative clinical study.Mean age of patients was 51 years（range：45 to 62 years）.Mean spherical equivalent refraction of the dominant eyes was-（7.25±2.18） D（range：-11.00 to-4.00 D）,and of the non-dominant eyes was-（7.22±2.12） D（range：-11.13 to-4.25 D）.All patients underwent asymmetric multifocal LASIK（multifocal LASIK with asymmetric correction of both eyes） using a Nidek EC-5000 CXⅡ excimer laser.The target refraction was-0.25 D for the dominant eyes and-0.75 D for the non-dominant eyes.Results： After six months,of the dominant eyes,mean spherical equivalent refraction was-（0.61±0.47） D（range：-1.38 to ＋0.50 D）,82% cases achieved distance UCVA of 0.8 or better,and 41% achieved near UCVA of 0.8 or better.Of the non-dominant eyes,mean spherical equivalent refraction was-（1.05±0.45） D（range：-1.75 to 0 D）,41% achieved distance UCVA of 0.8 or better,and 73% achieved near UCVA of 0.8 or better.Of the patients,100% achieved binocular distance UCVA of 0.8 or better,77% achieved binocular near UCVA of 0.8 or better.No eyes lost more than one line of BSCVA,and there were no serious complications after surgery.Conclusion： Asymmetric multifocal LASIK was a safe and effective surgery to correct myopia with presbyopia.