Vargas Veronica, Vejarano Felipe, Alió Jorge
Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain.
Research, Investigation & Development Department, VISSUM, Alicante, Spain.
Ophthalmol Ther. 2020 Dec;9(4):1003-1010. doi: 10.1007/s40123-020-00301-6. Epub 2020 Sep 23.
To perform a pilot evaluation of a novel pharmacological therapy for presbyopia in patients with previous corneal refractive surgery.
This interventional study included 130 presbyopic patients. The patients were divided into three groups: (1) LASIK group, which included patients with previous LASIK for myopia or hyperopia; (2) previous presbyopia surgery group, including patients with previous monovision or PresbyLASIK (PresbyMAX, SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany); and (3) control group, which included presbyopes without any corneal refractive procedure. The main reason for dividing them into groups is that we hypothesized that the previous presbyopia surgery group may have better outcomes as the patients already have an increased depth of field. The uncorrected near and distance visual acuity was measured before and 2 hours after the binocular instillation of the eye drop (FOV tears), as well as the objective scatter index (OSI), and pupil diameter in photopic and scotopic conditions. Side effects were reported as well.
There was a statistically significant improvement in the uncorrected near vision in all groups (p = 0.001). Ninety-one percent of the patients included in this study gained at least one line in near vision. All patients in the previous presbyopia surgery group gained at least one line in near vision. Six patients (13.9%) in the LASIK group and five (7.6%) in the control group did not gain any lines of near vision. There was no significant difference in the OSI, there was a significant change in pupil size in scotopic conditions in all groups (p = 0.001), and 5.3% of the patients reported having a headache as a side effect of the therapy.
Topical treatment with this pharmacological therapy offers a potential for near vision improvement in patients with previous corneal refractive surgery, especially in those with previous presbyopia surgery.
对一种用于曾接受角膜屈光手术患者的老花眼新型药物疗法进行初步评估。
这项干预性研究纳入了130例老花眼患者。患者被分为三组：（1）准分子激光原位角膜磨镶术（LASIK）组，包括曾接受近视或远视LASIK手术的患者；（2）既往老花眼手术组，包括曾接受单眼视或老视LASIK手术（PresbyMAX，德国施温德眼科技解决方案有限公司，克莱诺施泰姆）的患者；（3）对照组，包括未接受任何角膜屈光手术的老花眼患者。将他们分组的主要原因是我们假设既往老花眼手术组可能会有更好的结果，因为这些患者已经有了增加的景深。在双眼滴入眼药水（FOV泪液）前及滴入后2小时测量未矫正的近视力和远视力，以及客观散射指数（OSI），并测量明视和暗视条件下的瞳孔直径。同时报告副作用。
所有组的未矫正近视力均有统计学意义的改善（p = 0.001）。本研究中91%的患者近视力至少提高了一行。既往老花眼手术组的所有患者近视力至少提高了一行。LASIK组有6例患者（13.9%）、对照组有5例患者（7.6%）近视力未提高任何行。OSI无显著差异，所有组在暗视条件下瞳孔大小有显著变化（p = 0.001），5.3%的患者报告有头痛作为治疗的副作用。
这种药物疗法的局部治疗为曾接受角膜屈光手术的患者，尤其是曾接受老花眼手术的患者改善近视力提供了可能性。
