Levinger Eliya, Trivizki Omer, Pokroy Russell, Levartovsky Shmuel, Sholohov Galina, Levinger Samuel
*MD Enaim Refractive Surgery Center (EL, OT, SL), Jerusalem; Department of Ophthalmology (EL, OT), Sourasky Tel-Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University; Department of Ophthalmology (RP, GS), Hillel Yaffe Medical Center, Hadera; and Barzilai Medical Center (SL), Ashkelon, Israel.
Optom Vis Sci. 2013 Oct;90(10):1092-7. doi: 10.1097/OPX.0000000000000002.
To describe our experience with monovision excimer laser correction in individuals with myopic presbyopia.
This prospective interventional case series was conducted in a private refractive surgery center on 40 patients with presbyopia aged 40 years and older, who were treated with monovision refractive surgery between 2010 and 2011. The dominant eye was corrected for distance vision and the nondominant eye was corrected for near vision, with anisometropia of ≥1.00 diopters (D). All patients underwent comprehensive objective and subjective visual assessments, including a questionnaire that was filled out preoperatively and at 6 and 12 months postoperatively. The primary outcomes were preoperative and postoperative refraction, binocular visual acuity, stereopsis, contrast sensitivity, glare, and questionnaire results.
The 1-year follow-up was completed by 38 patients (95%). Preoperative and 1-year postoperative refraction of the distance eye spherical equivalent (SE), anisometropia SE, and uncorrected visual acuity were -4.05 ± 1.94 and -0.01 ± 0.22 D, 0.45 ± 0.50 and 1.73 ± 0.56 D, and 0.87 ± 0.2 and 0.09 ± 0.11 logMAR, respectively. Best-corrected visual acuity was unchanged. Both mean distance and near stereopsis decreased, from 52 to 142 seconds of arc and from 54 to 57 seconds of arc, respectively. Contrast sensitivity and glare decreased significantly. Patient satisfaction improved from 41.5 ± 30.4% to 85.2 ± 5.0% (range, 40 to 100%) at the 1-year follow-up.
Monovision excimer laser correction provides both effective and satisfactory results and should be considered as an option for individuals with myopic presbyopia suitable for, and interested in, refractive surgery.
描述我们对近视性老花眼患者进行单眼视准分子激光矫正的经验。
本前瞻性干预性病例系列研究在一家私立屈光手术中心对40例40岁及以上的老花眼患者进行，这些患者在2010年至2011年间接受了单眼视屈光手术。优势眼矫正为远视力，非优势眼矫正为近视力，屈光参差≥1.00屈光度（D）。所有患者均接受了全面的客观和主观视力评估，包括术前以及术后6个月和12个月填写的问卷。主要结局指标为术前和术后的屈光状态、双眼视力、立体视、对比敏感度、眩光及问卷结果。
38例患者（95%）完成了1年的随访。随访1年时，远用眼球镜等效度（SE）、屈光参差SE及未矫正视力的术前和术后值分别为-4.05±1.94 D和-0.01±0.22 D、0.45±0.50 D和1.73±0.56 D、0.87±0.2和0.09±0.11 logMAR。最佳矫正视力无变化。平均远立体视和近立体视均下降，分别从52角秒降至142角秒和从54角秒降至57角秒。对比敏感度和眩光显著下降。在1年随访时，患者满意度从41.5±30.4%提高到85.2±5.0%（范围40%至100%）。
单眼视准分子激光矫正提供了有效且令人满意的结果，对于适合并对屈光手术感兴趣的近视性老花眼患者应考虑将其作为一种选择。
