Macsai Marian Sue, Fontes Bruno Machado
Department of Ophthalmology, Evanston Northwestern Healthcare, Illinois 060026, USA.
Curr Opin Ophthalmol. 2008 Jan;19(1):18-21. doi: 10.1097/ICU.0b013e3282f14d9f.
Presbyopia-correcting intraocular lenses are widely available. Residual ametropia is one of the most common issues that can result in patient dissatisfaction. Options for correcting refractive surprises include piggyback intraocular lens implantation, corneal incisional surgery and laser correction. Excimer laser surgery is a safe and predictable method to correct residual amounts of ametropia in pseudophakic patients with monofocal intraocular lenses; however, there is scant published literature regarding this technique.
Presbyopia-correcting intraocular lenses require emmetropia for the best visual outcome, as small amounts of astigmatism or residual refractive errors can limit their visual performance. Laser-assisted in-situ keratomileusis and photorefractive keratectomy are safe and effective results in pseudophakic patients. Surgeons can refine the refractive outcome after intraocular lens implantation with the excimer laser to achieve better results and higher patient satisfaction.
Excimer laser corneal surgery for fine-tuning residual ametropia after presbyopia-correcting intraocular lenses is a safe adjunct treatment to increase patient satisfaction. Which technique (photorefractive keratectomy or laser-assisted in-situ keratomileusis) to use depends on surgeon preference and patient characteristics, as both demonstrate similar results in published literature. Knowledge of all available refractive methods and technologies are crucial for improving outcomes in these patients.
用于矫正老花眼的人工晶状体已广泛应用。残余屈光不正（屈光参差）是导致患者不满意的最常见问题之一。矫正屈光意外情况的选择包括二期人工晶状体植入、角膜切开手术和激光矫正。准分子激光手术是一种安全且可预测的方法，用于矫正单焦点人工晶状体的假晶状体患者的残余屈光不正量；然而，关于该技术的已发表文献很少。
用于矫正老花眼的人工晶状体需要正视才能获得最佳视觉效果，因为少量散光或残余屈光不正会限制其视觉性能。准分子激光原位角膜磨镶术和准分子激光角膜切削术在假晶状体患者中取得了安全有效的结果。外科医生可以使用准分子激光在人工晶状体植入后优化屈光结果，以获得更好的效果和更高的患者满意度。
在用于矫正老花眼的人工晶状体植入后，使用准分子激光角膜手术微调残余屈光不正是一种安全的辅助治疗方法，可提高患者满意度。使用哪种技术（准分子激光角膜切削术或准分子激光原位角膜磨镶术）取决于外科医生的偏好和患者特征，因为在已发表的文献中两者显示出相似的结果。了解所有可用的屈光方法和技术对于改善这些患者的治疗效果至关重要。
