Kohnen Thomas, Biller Marvin Lucas, Lwowski Christoph, Böhm Myriam, Kaiser Klemens Paul
Department of Ophthalmology, Goethe University, Frankfurt am Main.
Dtsch Arztebl Int. 2025 Sep 5;122(18):501-507. doi: 10.3238/arztebl.m2025.0094.
Accommodation is the eye's ability to dynamically adjust its refractive power in order to focus images at varying distances sharply onto the retina. Presbyopia is the progressive deficit of accommodation that develops as an individual becomes older. An estimated 1.8 billion people worldwide have presbyopia.
This narrative review is based on pertinent publications retrieved by a PubMed search using the terms "presbyopia," "presbyopic," "intraocular lens," "corneal inlay," and "presbyLasik," with particular attention given to prospective and retrospective studies, systematic reviews, and meta-analyses published in English or German up to February 2025. Additionally, clinical and surgical experiences from the Universitätsklinikum Frankfurt am Main (Germany) were taken into account.
Many different techniques for the correction of presbyopia have been developed and studied, both nonsurgical and surgical. They differ from one another in invasiveness, the range of corrected vision, and expected optical and visual quality outcomes. Proper patient selection and precise preoperative diagnostic evaluation are prerequisites for success. The highest spectacle independence rate, of 96%, was achieved in a study with only 27 patients, in which multifocal intraocular lenses were implanted during cataract surgery or refractive lens exchange, with postoperative satisfaction exceeding 90%.
Presbyopia can be corrected by either nonsurgical or surgical means. However, the restoration of natural accommodation or a fully equivalent mechanism has not yet been achieved.
调节是眼睛动态调整其屈光力的能力，以便将不同距离的图像清晰地聚焦在视网膜上。老花眼是随着个体年龄增长而出现的调节能力逐渐衰退。据估计，全球有18亿人患有老花眼。
本叙述性综述基于通过PubMed检索获得的相关出版物，检索词为“老花眼”“老花眼的”“人工晶状体”“角膜镶嵌物”和“老视准分子原位角膜磨镶术”，特别关注截至2025年2月以英文或德文发表的前瞻性和回顾性研究、系统评价和荟萃分析。此外，还考虑了德国美因河畔法兰克福大学医院的临床和手术经验。
已经开发并研究了许多不同的老花眼矫正技术，包括非手术和手术技术。它们在侵入性、矫正视力范围以及预期的光学和视觉质量结果方面彼此不同。正确的患者选择和精确的术前诊断评估是成功的先决条件。在一项仅27例患者的研究中，多焦点人工晶状体在白内障手术或屈光性晶状体置换术中植入，实现了96%的最高脱镜率，术后满意度超过90%。
老花眼可以通过非手术或手术方法矫正。然而，自然调节或完全等效机制的恢复尚未实现。
