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目的:观察不对称多焦点激光原位屈光性角膜磨镶术(LASIK)治疗近视合并老视的有效性和安全性。方法:前瞻性非随机临床研究近视合并老视患者22例(44眼),平均年龄51岁。主视眼术前屈光度等值球镜为-(7.25±2.18)D,非主视眼术前屈光度等值球镜为-(7.22±2.12)D。对所有患者施行双眼不对称矫正的多焦点LASIK术,主视眼预矫正目标为-0.25 D,非主视眼预矫正目标为-0.75 D。使用的设备为尼德克EC-5000CXⅡ准分子激光系统。结果:手术6个月后,主视眼屈光度等值球镜为-(0.61±0.47)D,82%的术眼裸眼远视力达到0.8或以上,41%的术眼裸眼近视力达到0.8或以上。非主视眼屈光度等值球镜为-(1.05±0.45)D,41%的术眼裸眼远视力达到0.8或以上,73%的术眼裸眼近视力达到0.8或以上。术后100%的患者双眼裸眼远视力达到0.8或以上,77%的患者双眼裸眼近视力达到0.8或以上。所有眼均未丧失1行以上的最佳矫正视力,术中及术后无严重并发症。结论:不对称多焦点LASIK术是一种安全、有效的矫正近视合并老视的手术方法。
Objective: To observe the effectiveness and safety of asymmetric multifocal laser in situ keratomileusis (LASIK) in the treatment of myopia with presbyopia. Methods: Prospective non-randomized clinical study of myopia with presbyopia in 22 patients (44 eyes), mean age 51 years. The preoperative spherical equivalent was (-) 7.25 ± 2.18 D, while the non - dominant preoperative diopter spherical equivalent was - (7.22 ± 2.12) D. Multifocal LASIK with asymmetric binocular correction was performed on all patients with a predominantly orthognostic target of -0.25 D in the dominant eye and -0.75 D in the non-dominant eye. The equipment used was a Nidek EC-5000CX II excimer laser system. Results: After 6 months of operation, the spherical equivalent of the dominant eye refraction was - (0.61 ± 0.47) D, the open eye vision of 82% of the eyes reached 0.8 or above, and the naked eye near eyesight of the 41% eyes reached 0.8 or above . The non-dominant refraction spherical equivalent was - (1.05 ± 0.45) D, with 41% of the unaided eyes having a distance vision of 0.8 or above and 73% of the eyes having a near vision of 0.8 or above. Postoperative 100% of patients with binocular vision far vision of 0.8 or more, 77% of the eyes of patients with uncorrected visual acuity reached 0.8 or more. All eyes did not lose more than 1 line of the best corrected visual acuity, intraoperative and postoperative no serious complications. Conclusion: Asymmetric multifocal LASIK is a safe and effective surgical method for correcting myopia with presbyopia.