Bilbao-Calabuig R, Llovet-Osuna F
Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera Madrid, Madrid, España.
Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera Madrid, Madrid, España.
Arch Soc Esp Oftalmol. 2017 Sep;92(9):426-435. doi: 10.1016/j.oftal.2017.04.005. Epub 2017 Jun 16.
Presbyopia is the most prevalent refractive error. With a progressive aging population, its surgical correction is an important challenge for the ophthalmology community, as well as the millions of patients who suffer from it, and who are increasingly demanding alternatives to its correction with glasses or contact lenses.
A review is presented with a synthesised discussion on the pathophysiological theories of presbyopia and an updated and analytical description of the non-lens involvement surgical techniques used to treat presbyopia.
Corneal procedures include various types of corneal implants and photo-ablative techniques that generate a multifocal cornea, or monovision. Scleral procedures exert a traction on supralenticular sclera that supposedly would improve the amplitude of accommodation.
None of the techniques are able to completely eliminate the need for near -vision glasses, but many of them manage to improve the refractive status of the patients. More studies with rigorous and standardised methods and longer follow-up are needed to evaluate the changes in the near vision of the patients, in order to corroborate the real and practical usefulness of many of these techniques.
老花眼是最常见的屈光不正。随着人口老龄化的加剧，其手术矫正对眼科界以及数百万受其影响的患者来说都是一项重大挑战，这些患者对眼镜或隐形眼镜矫正之外的替代方法的需求也日益增加。
本文对老花眼的病理生理理论进行了综合讨论，并对用于治疗老花眼的非晶状体介入手术技术进行了更新和分析性描述。
角膜手术包括各种类型的角膜植入物和产生多焦点角膜或单眼视的光消融技术。巩膜手术对晶状体上巩膜施加牵引力，据推测这会改善调节幅度。
这些技术都无法完全消除对近视力眼镜的需求，但其中许多技术确实能改善患者的屈光状态。需要更多采用严格标准化方法且随访时间更长的研究来评估患者近视力的变化，以证实这些技术中许多技术的实际实用性。
