Hamilton David Rex, Davidorf Jonathan M, Maloney Robert K
Jules Stein Eye Institute and the UCLA School of Medicine, Los Angeles, California 90024, USA.
Ophthalmology. 2002 Nov;109(11):1970-6; discussion 1976-7. doi: 10.1016/s0161-6420(02)01252-6.
To examine the safety and efficacy of anterior ciliary sclerotomy to restore accommodation in the presbyopic eye.
Prospective nonrandomized comparative single-center clinical trial.
Nine presbyopic subjects with no prior ocular surgery except corneal refractive procedures were enrolled.
One eye from each subject was chosen, in consultation with the patient, to undergo anterior ciliary sclerotomy. The contralateral eye of each subject served as a control. Examinations were performed preoperatively, and at 1 day, 1 week, 1 month, and 6 months after surgery.
(1) Accommodative amplitude, measured by two methods, (2) Jaeger reading vision at 14 inches wearing best distance correction, (3) manifest refraction, (4) assessment of operative complications.
For the nine study eyes, there was no statistically significant change between the average accommodative amplitude at the preoperative visit (1.11 diopter [D]) and the 1-month postoperative visit (1.19 D, P = 0.55) nor at the 6-month postoperative visit (1.31 D, P = 0.21) in the study eyes. There was no significant difference between the study and control eyes' change in accommodative amplitude at 6 months (P = 0.43). Logarithm of the minimum angle of resolution equivalent of Jaeger reading vision in the study eyes at 14 inches wearing best distance correction showed no statistically significant change from the preoperative visit (0.53 [20/70]) at the 1-month postoperative visit (0.41 [20/50], P = 0.07) or at the 6-month postoperative visit (0.48 [20/60], P = 0.22). There was no significant change in manifest refraction spherical equivalent in the study eyes at 1 and 6 months postoperatively. One eye experienced a perforation of the anterior chamber during surgery. A second eye experienced mild postoperative anterior segment ischemia manifested by sectoral iris akinesis.
Anterior ciliary sclerotomy does not restore accommodation in presbyopic eyes and can cause significant complications.
探讨睫状肌前巩膜切开术恢复老视眼调节功能的安全性和有效性。
前瞻性非随机对照单中心临床试验。
纳入9例除角膜屈光手术外未接受过眼部手术的老视患者。
与患者协商后，选取每位患者的一只眼睛进行睫状肌前巩膜切开术。每位患者的对侧眼作为对照。术前、术后1天、1周、1个月和6个月进行检查。
（1）通过两种方法测量的调节幅度；（2）佩戴最佳矫正远视力眼镜时14英寸处的耶格阅读视力；（3）显验光；（4）手术并发症评估。
对于9只研究眼，术前平均调节幅度（1.11屈光度[D]）与术后1个月（1.19 D，P = 0.55）及术后6个月（1.31 D，P = 0.21）之间无统计学显著变化。研究眼与对照眼在术后6个月调节幅度变化方面无显著差异（P = 0.43）。佩戴最佳矫正远视力眼镜时，研究眼在14英寸处的耶格阅读视力的最小分辨角对数等效值在术后1个月（0.41 [20/50]，P = 0.07）或术后6个月（0.48 [20/60]，P = 0.22）与术前（0.53 [20/70]）相比无统计学显著变化。研究眼术后1个月和6个月的显验光球镜等效值无显著变化。一只眼在手术期间发生前房穿孔。另一只眼术后出现轻度前段缺血，表现为扇形虹膜运动不能。
睫状肌前巩膜切开术不能恢复老视眼的调节功能，且可导致严重并发症。
