LaserACE激光巩膜手术矫正老视

One-year results of LaserACE laser scleral surgery for presbyopia

目的 评价LaserACE激光巩膜手术矫正老视术后12个月的临床效果.方法 回顾性病例研究.纳入老视患者8例（16眼）,进行LaserACE激光巩膜矫正手术.术后1、3、6、12个月复查,测量远中近距离视力、近附加、阅读速度、眼压（IOP）和等效球镜度（SE）,并通过Catquest-9SF问卷评估患者主观感受.采用重复测量方差分析和配对t检验对数据进行处理.结果 术后均无明显并发症,无最佳矫正远视力丢失者.术后1、3、6、12个月双眼及单眼近距离视力较术前相比明显提高,差异有统计学意义（F=10.79、26.64,P＜0.01）.手术前后各时间点双眼及单眼中距离视力差异有统计学意义（F=5.11、8.10,P＜0.05）,但术后12个月双眼中距离视力与术前差异无统计学意义.手术前后双眼及单眼远视力差异无统计学意义.术后近附加较术前下降（F=69.79,P＜0.01）;平均阅读速度较术前均有显著提高（F=1 1.27,P＜0.01）.手术前后IOP、SE无显著改变.结论 LaserACE激光巩膜气化手术是安全的,术后12个月内患者近、中距离视力提高,且远视力不受影响。

Objective To evaluate the one-year results of LaserACE laser scleral surgery in the treatment of presbyopia.Methods This was a retrospective case study.LaserACE laser scleral surgery was performed on 16 eyes of 8 patients.The follow-up time was 12 months.Uncorrected near, intermediate and distance visual acuity （VA）, near add, reading speed, spherical equivalent and intraocular pressure were measured at 1, 3, 6, and 12 months after surgery.The patients＇ subjective experience was evaluated with the Catquest-9SF questionnaire.The data were analyzed with repeated measures analysis of variance and paired t test.Results All cases were uneventful.No patient lost BCVA lines after surgery.Mean binocular and monocular uncorrected near visual acuity （UNVA） increased significantly at 1, 3, 6 and 12 months after surgery （F=10.79, 26.64, P〈0.01）.Mean UNVA 12 months postoperatively improved from preoperative UNVA （P〈0.05）.Mean binocular and monocular uncorrected intermediate visual acuity （UIVA） increased after the surgery （F=5.11, 8.10, P〈0.05）.Mean binocular UIVA at 12 months postoperatively was not different from preoperative UIVA （P〉0.05）.No significant differences in binocular or monocular uncorrected distance visual acuity （UDVA） were detected postoperatively.Mean postoperative near add was significantly reduced （F=69.79, P〈0.01）.Mean reading speed was faster after the surgery （F=11.27, P〈0.01）.Conclusion LaserACE laser scleral surgery appears to improve intermediate and near visual acuity for presbyopic patients and has no effect on distance visual acuity postoperatively.It is safe and has the potential to improve patient intermediate and near vision over a 12-month follow-up period.