J Refract Surg. 2021 Jan 1;37(1):16-24. doi: 10.3928/1081597X-20201013-03.
To evaluate the visual outcomes of patients with presbyopic hyperopia, comparing the current standard of monovision treatment with a novel bilateral presbyopic LASIK (Custom-Q mode) technique.
This prospective comparative study of consecutive eligible patients with presbyopic hyperopia undergoing a bilateral presbyopic laser in situ keratomileusis technique was conducted between January 2018 and February 2019. After contact lens-simulated monovision measurements were obtained, the non-dominant eyes had a negative aspheric ablation profile planned using the Custom-Q nomogram (Alcon Laboratories, Inc). The dominant eye was operated on with a positive aspheric ablation profile. Visual acuity testing, refraction, corneal asphericity (▵Q), higher order aberrations, and a satisfaction questionnaire (National Eye Institute Refractive Error Quality of Life) were evaluated after the monovision trial and postoperatively.
Twenty-eight patients, with a mean age of 56.03 ± 4.31 years, were included in the study. At 6 months, 100% of patients achieved 20/20 or better binocular uncorrected distance visual acuity (UDVA) versus 57% in the monovision group, 100% of patients achieved 20/25 or better binocular uncorrected intermediate visual acuity versus 32% in the monovision group, and 92.86% of patients achieved 20/25 or better binocular uncorrected near visual acuity (UNVA) in both groups. In contact lens monovision simulation, no patient reached a UDVA of 20/50 or better, with only 3.6% having a UNVA of 20/40 or better. The questionnaire demonstrated high patient satisfaction.
The outcomes confirm the superiority of increased depth of focus using negative spherical aberration modulation in the non-dominant eye compared with contact lens monovision. They also demonstrate the effectiveness of positive spherical aberration induction to improve intermediate and near vision in the dominant eye. [J Refract Surg. 2021;37(1):16-24.].
评估远视性老视患者的视觉结果，比较当前的单视治疗标准与新型双侧老视 LASIK（Custom-Q 模式）技术。
这是一项前瞻性、连续入选远视性老视患者的对照研究，这些患者均接受双侧老视激光原位角膜磨镶术治疗。在获得隐形眼镜模拟单视测量值后，使用 Custom-Q 图表（爱尔康实验室公司）为非主导眼规划负球差消融方案。主导眼则采用正球差消融方案进行手术。在单视试验和术后，评估视力测试、屈光度、角膜非球面性（▵Q）、高阶像差和满意度问卷（国家眼科研究所屈光不正生活质量）。
28 例患者，平均年龄 56.03±4.31 岁，纳入本研究。6 个月时，100%的患者双眼未矫正远视力（UDVA）达到 20/20 或更好，而单视组为 57%；100%的患者双眼未矫正中间视力达到 20/25 或更好，而单视组为 32%；两组患者双眼未矫正近视力（UNVA）均达到 20/25 或更好的比例分别为 92.86%和 92.86%。在隐形眼镜单视模拟中，没有患者的 UDVA 达到 20/50 或更好，只有 3.6%的患者 UNVA 达到 20/40 或更好。问卷调查显示患者满意度较高。
研究结果证实，与隐形眼镜单视相比，非主导眼负球差调制增加景深具有优越性。研究结果还表明，在主导眼诱导正球差可有效改善中距离和近距离视力。[J Refract Surg. 2021;37(1):16-24.]。
