飞秒激光INTRACOR技术矫正老视

目的 评价飞秒激光INTRACOR技术治疗老视的安全性、有效性和可预测性.方法 回顾性病例研究.老视患者28例(28眼),选取非主导眼采用TPV520F飞秒激光系统INTRACOR技术进行老视矫正,检测手术前后的裸眼远、近视力,屈光度,眼压,角膜内皮计数,角膜地形图,对比敏感度,眩光敏感度及患者术后主观感受.术后随访6个月.采用配对t检验或配对Wilcoxon秩和检验.结果 所有手术均顺利,术后6个月裸眼远视力中位数为0.0(0.2～-0.1)术前为0.0(0.2～-0.1)]logMAR,两者差异无统计学意义;术后6个月裸眼近视力中位数为0.25(0.4～0.0)术前为0.5(1.0～0.3)]logMAR,较术前平均提高(6.25±1.74)行,差异有统计学意义(t=18.66,P＜0.01).术后6个月球镜度中位数为-0.25(-0.75～0.25)D,柱镜度中位数为0.0(-0.75～0.25)D,等效球镜中位数为-0.37(-0.75～0.25)D,术前分别为+0.5(-0.25～1.0)D、0.0(-0.5～0.0)D、+0.25(-0.12～0.75)D,手术前后球镜和等效球镜度差异有统计学意义(Z=-4.50、-4.57,P＜0.01),柱镜度差异无统计学意义,术眼屈光度轻度近视漂移.眼内压、角膜内皮计数及对比敏感度眩光敏感度手术前后比较差异均无统计学意义,术后6个月采用生活质量调查表进行量化评价得分为89±14,满意度高.结论 INTRACOR飞秒技术治疗老视术后能显著提高患者近视力,对远视无明显影响,有较好的安全性和有效性.

Evaluation of femtosecond laser based on the INTRACORE technique for treating presbyopia

Objective To evaluate the safety, efficacy, and stability of the INTRACOR femtosecond laser-based intrastromalproeedure to treat presbyopia. Methods In a retrospective case-series study, the nondominant eye （28 eyes in 28 presbyopic cases） was treated with femtosecond laser based on the INTRACORE technique and comparisons were made before and after the operation for near and distance visual acuity, refractive error, intraoeular pressure, endothelial cell density, corneal topography, contrast sensitivity, glare sensitivity and patient satisfaction. All patients were followed up for 6 months. Data were analyzed using paired t test or paired Wilcoxon rank sum test. Results All cases were uneventful. Mean distance visual acuity （VA） at 6 months postoperatively was 0.0 logMAR （range, 0.2 to -0.1） compared to a preoperative VA of 0.0 logMAR （range, 0.2 to -0.1）. The difference was not significant. Mean near visual acuity at 6 months postoperatively was 0.25 logMAR （range, 0.4 to 0.0） compared to 0.5 logMAR （range, 1.0 to 0.3） preoperatively. The elevated postoperative value （6.25±1.74 lines） was significantly different than the preoperative value （t=18.66, P〈0.01）. The mean values for spherical power, cylinder equivalent and spherical equivalent at 6 months postoperatively were -0.25 D （range, -0.75 to 0.25 D）, 0.0 D （range, -0.75 to 0.25 D） and -0.37 D （range, -0.75 to 0.25 D）, respectively, compared to preoperative values of 0.5 D （range, -0.25 to 1.0 D）, 0.0 D （range, -0.5 to 0.0 D） and ＋0.25 D （range, -0.12 to 0.75 D）, respectively. The differences before and after the operation were significant for both spherical power and spherical equivalent values （Z=-4.50, -4.57, both P〈0.01）. However, there was no significant difference in the cylinder equivalent value before and after the operation. The INTRACORE treatment induced a slight myopic shift of -0.54 D and there were no significant differences for intraocular pressure, endothelial cell density, contrast sensitivity and glare sensitivity before and after the operation. The average score was 89±14 for the quality of life questionnaire at 6 months postoperatively. Conclusion Femtosecond laser-based treatment using the INTRACORE technique appears to improve near visual acuity in presbyopic patients but there was no apparent effect on distance visual acuity. Femtosecond laser-based treatment with the INTRACORE technique is safe and has good visual outcomes.