单眼视LASIK治疗伴有老视的屈光不正临床观察

目的:探讨单眼视准分子激光原位角膜磨镶术(单眼视LASIK)治疗伴有老视的屈光不正对患者视觉质量、生活质量的影响。方法:屈光不正伴老视的患者172例中124例施行单眼视LASIK(主视眼按最佳矫正远视力完全矫正,非主视眼近视者低矫-0.75~-2.00D,远视者过矫0.75~2.00D),35例放弃手术,13例患者双眼全部矫正。观察术后1d;1wk;3mo时的检查结果。结果:术后3mo单眼视LASIK组124例患者双眼远视力0.7~1.2,双眼近视力J1~J3。无因为难以耐受的不适而需要戴镜补充矫正或再次手术者。双眼完全矫正组术后双眼远视力0.7~1.2,双眼近视力J3~J6,8例(62%)视近困难,需配近用眼镜。结论:单眼视LASIK治疗伴有老视的屈光不正安全有效。单眼视治疗在设计手术方案时需根据患者年龄及调节能力、近附加度数、阅读距离、工作性质等综合考虑。     

Q值优化非球面切削单眼视LASIK术后视觉效果分析

目的：评价利用Q值优化的非球面切削单眼视LASIK手术方式矫正近视散光联合老视的单眼及双眼视觉效果。 方法：选择2006-08-01/2009-03-31之间在我院利用Carl Zeiss Meditec CRS-Master软件及MEL80准分子激光进行Q值优化的非球面切削单眼视LASIK手术的近视或者近视散光联合老视的40名连续随访患者（80眼）,术后1d;1wk;1,3,6mo及1a进行验光、单眼及双眼视近及视远裸眼视力、角膜曲率、像差检查,术后1wk;1,3,6mo及1a进行对比敏感度及立体视觉检查进行视觉质量评估, 并在术后6mo进行患者近距离工作视觉疲劳问卷调查。 结果：Q值优化的非球面切削单眼视LASIK术后视觉质量研究结果如下：术后6mo等效球镜屈光度与目标屈光度相比92%在±0.50D以内,99%在±1.00D,术后3mo~1a的屈光值的变化为-0.06±0.37D。术后1mo主视眼的裸眼远视力95%达到20/20;双眼裸眼近视力87.5%达到J2,100%达到J5。术后1wk, 双眼对比敏感度与术前矫正后相比有下降趋势,术后1~3mo逐渐恢复。术后1wk时,近立体视锐度有所降低(P<0.05),其他立体视锐度均无明显改变(均为P>0.05)。术后患者近距离工作视疲劳症状明显改善。 结论：Q值优化的非球面切削单眼视LASIK手术方式,对于中度近视至高度近视及散光联合老视患者,是一种耐受性好,稳定安全有效的治疗方法。     

大龄近视患者行LASIK的体会

目的:探讨大龄近视伴调节力下降患者行准分子激光原位角膜磨镶术(LASIK)的手术设计对视力的影响。方法:屈光不正伴老视的患者32例63眼中27例53眼行单眼LASIK主视眼按最佳矫正远视力完全矫正,非主视眼近视欠矫-0.5～-2.00D,5例10眼双眼远视力全部矫正。观察术后3mo视力。结果:术后3mo,27例53眼远视力主视眼1.0～1.2,非主视眼0.3～0.6;近视力主视眼0.6,非主视眼1.0。5例10眼双眼远视力完全矫正。结论:LASIK矫正大龄调节力下降患者,在设计手术方案时需按患者要求、年龄等综合考虑。     

Q值调整联合单眼视LASIK治疗近视伴老视的疗效

目的：评价Q值调整联合单眼视LASIK治疗近视伴老视的效果。方法：回顾性病例对照研究。纳 入2017年2月至2018年12月在上海爱尔眼科医院国际屈光中心实施老视手术患者。34例非主视眼采用Q值调整联合单眼视LASIK治疗老视,非主视眼设定目标Q值比术前Q值向更负的方向变化 0.3～0.5,保留的屈光度在-1.00～-0.25 D范围。对照组43例匹配年龄和非主视眼屈光度,保留的屈光度在-1.00～-0.25 D范围,不做Q值调整;2组主视眼均全矫。记录非主视眼的裸眼远、中、近 视力,角膜中央3 mm屈光度,前表面Q值,总像差,低阶像差,高阶像差,球差,角膜球差,离焦和彗差。记录双眼裸眼远、中、近视力。组间连续型变量比较采用独立样本t检验,使用Spearman相关检验近视力与离焦、术后Q值及瞳孔变化幅度的相关性。结果：术后3个月,Q值调整联合单眼视组 非主视眼近视力较对照组好（t=0.597,P=0.021）,远视力和中视力与对照组相比差异无统计学意义。 Q值调整联合单眼视组93%的患者双眼近视力（LogMAR）在0或以上,比对照组的86%高（χ2 =27.127, P<0.001）。与对照组相比,Q值调整组总像差、低阶像差、角膜球差、离焦较对照组大（t=-2.210, P=0.032;t=-2.135,P=0.038;t=-2.108,P=0.038,t=-2.190,P=0.034）。77例患者近视力与术后自然 光线瞳孔下的离焦、术后Q值及调节引起的瞳孔变化均呈负相关（r1=-0.251,P1=0.028;r2=-0.543, P2<0.001;r3=-0.417,P3<0.001）。结论：采用Q值调整联合单眼视LASIK治疗老视在提高近视力的同 时,不影响远视力。Q值向负向调整,增加了中央角膜的屈光度、离焦和球差,在视近时通过瞳孔直径的变化,提高近视力,同时不会明显影响远视力。     

准分子激光原位角膜磨镶术治疗远视眼老视的临床观察

目的 探讨准分子激光原位角膜磨镶术(LASIK)治疗远视眼老视的临床效果.方法 回顾性病例分析研究.收集32例(64只眼)因远视眼老视行LASIK患者的资料.术前屈光度数:球镜为+0.75～+3.00 D,柱镜为0.00～+1.75 D.术后预期目标屈光度数:主视眼为0.00～-0.50 D视远,非主视眼为-1.50～-2.50 D视近,目标近视力等于或高于J3.术后随访时间12个月,观察术后双眼裸眼远近视力、角膜形态、屈光度数及对比敏感度等.本研究采用t检验、X2检验、SNK-q检验方法对数据进行统计学分析.结果 LASIK术后12个月双眼裸眼远视力≥0.8且近视力等于或高于J3及等于或高于J4的患者分别为53.1%(17/32)及87.5%(28/32).术后不同时间角膜屈光力较术前[角膜直径3 mm区域为(44.12±1.38)D、5 mm区域为(43.42±1.53)D]均有明显增加,且对应的角膜非球面参数Q值,如主视眼术后1、3、 6、 12个月分别为-0.514±0.053、-0.416±0.065、-0.389±0.076、-0.368±0.087,亦呈负值增加(t=19.25,12.14,9.82,8.11;P<0.01).术后12个月等效球镜屈光度数与预期目标差值在±0.50 D和±1.00 D以内者主视眼分别为87.5%(28/32)、100.0%(32/32),非主视眼分别为56.2%(18/32)、90.6%(29/32).术后6个月双眼各空间频率对比敏感度与术前比较,差异均无统计学意义(t:0.63,0.45,0.37,1.06,0.64;P0.05);术后12个月主诉有干眼症状的患者占15.6%(10/23),满意度调查84.4%(27/32)患者对疗效满意.结论 根据单眼视原理采用LASIK治疗远视眼老视可获得较好的临床效果,但其远期疗效和稳定性有待进一步观察.     

单眼视设计的人工晶状体眼视功能临床研究

目的 探讨应用单眼视原理设计双眼白内障超声乳化联合植入单焦点人工晶状体术后的视功能情况.方法 对双眼年龄相关性白内障患者42例(84只眼),分为常规组21例(42只眼)及单眼视组21例(42只眼).常规行白内障超声乳化联合折叠式人工晶状体植入术.分别记录术前最佳矫正视力及术后1周单眼裸眼远、近视力及双眼裸眼远、近视力.采用SAS8.2统计软件对结果进行统计学分析.结果 (1)术前平均最佳矫正视力常规组4.44,单眼视组4.47(P ＞0.05),患者平均年龄常规组71岁,单眼视组69.5岁(P ＞0.05),差异无统计学意义.(2)术后1周单眼裸眼远视力常规组4.90,单眼视组:优势眼4.94(P ＞0.05),与常规组比较差异无统计学意义;非优势眼4.71(P < 0.05),与常规组比较差异有统计学意义.术后1周单眼近视力常规组4.36,单眼视组:优势眼4.37(P＞0.05),与常规组比较差异无统计学意义;非优势眼4.78(P < 0.05),与常规组比较差异有统计学意义.(3)术后1周双眼裸眼远视力常规组4.91,单眼视组4.91(P ＞0.05),与常规组比较差异无统计学意义;术后1周双眼近视力常规组4.42,单眼视组4.78(P < 0.05),与常规组比较差异有统计学意义.结论 单眼视设计的人工晶状体眼术后双眼远视力与常规设计人工晶状体眼相同,但近视力明显好于常规设计.按照单眼视原理设计人工晶状体可以较好的临床应用.     

非球面优化单眼视准分子激光手术治疗近视合并老视的短期临床观察

目的探讨非球面优化单眼视准分子激光治疗近视合并老视的安全性和有效性。方法选择2017年3~11月在我院视光中心行非球面优化单眼视准分子激光治疗的患者30例(60只眼)。主视眼实施常规模式的准分子激光原位角膜磨镶术(LASIK)矫正全部屈光度,非主视眼实施Q值调整的非球面切削的LASIK。术后随访观察患者术后1 d、1个月、3个月的裸眼远近视力、对比敏感度、角膜地形图变化情况。结果所有患者手术均顺利,无角膜瓣有关的并发症;术后所有患者均没有角膜水肿、Haze反应、高眼压等术后并发症。术后1 d、1个月、3个月,主视眼远视力分别为1.02±0.28、1.10±0.15及1.07±0.20;非主视眼远视力分别为0.8±0.17、1.03±0.26及1.09±0.18。术后1个月至3个月患者远视力趋于稳定。非主视眼术后1 d为0.37±0.10,术后1个月时达到0.51±0.19,3个月时基本稳定。术后3个月时非主视眼中有90%(27/30)≥0.33,70%(21/30)≥0.5。主视眼术后1、3个月的Q值向正值方向发展,分别为0.44±0.20、0.40±0.26,与术前比较差异有统计学意义(P<0.05)。非主视眼术后1、3个月的Q值分别为-0.55±0.26、-0.48±0.29。患者术后1、3个月患者的对比敏感度逐步达到术前水平。结论非球面优化单眼视准分子激光治疗近视合并老视是安全性和有效性的。     

LASIK术后主视眼与非主视眼一致性平衡情况分析

目的:评估LASIK术后主视眼与非主视眼间的一致性平衡变化情况。方法:采用回顾性分析的方法,收集我院行LASIK术的患者37例74眼的术前(双眼均矫正为最佳矫正视力,而不是采取主视眼足矫、非主视眼稍欠矫的方法)、术后1d;1,3,6mo裸眼视力,将患者分为3组,第一组其主视眼视力=非主视眼视力,第二组主视眼视力>非主视眼视力,第三组主视眼视力<非主视眼视力,并进行统计分析对比。结果:除了术后1d与术前相比有统计学上意义外,术后1,3,6mo与术前相比均无统计学上意义。结论:LASIK术后主视眼和非主视眼状况1mo及以后与术前相比情况稳定,无明显变化,LASIK术并未改变患者的主视眼、非主视眼两眼间的一致性平衡状态。     

可调节人工晶状体预留度数设计的临床观察

目的 观察可调节人工晶状体预留度数植入术后的视觉质量及调节力的变化.方法 将30例(60只眼)植入可调节人工晶状体,其中将15例(30只眼)植入度数设计(SRKT公式)为主视眼植入理论值过矫0.5D度数,非主视眼植入理论值过矫1.0D度数作为研究组;随机选取15例(30只眼)植入度数设计为主视眼和非主视眼均植入SRKT公式理论值度数作为对照组.手术后随访3个月以上,观察远视力、近视力,最佳矫正远、近视力;调节力的测定(分别用主观法和客观法);双眼合视的远、近视力.结果 研究组术后屈光度主视眼为(0.512±0.15)D,非主视眼为(1.13±0.12)D.研究组与对照组主视眼裸眼远视力及最佳矫正远视力分别为0.89±0.11、0.91±0.12和0.97±0.23、0.99±0.14,差异均无统计学意义.33cm近视力及最佳矫正近视力主视眼分别为0.63±0.16、0.48±0.23和0.97±0.25、0.86±0.14,差异有统计学意义;非主视眼最佳矫正近视力为0.99±0.15和0.89±0.14,差异有统计学意义.两组调节幅度主观法分别为(3.35±0.71)D和(3.27±1.32)D,差异无统计学意义;客观法主视眼分别为(0.38±0.12)D和(0.37±0.08)D,差异无统计学意义.双眼合视的远视力分别为0.99±0.11和0.98±0.21,差异无统计学意义;双眼合视的近视力分别为0.91±0.20和0.61±0.17,差异有统计学意义.结论 植入可调节人工晶状体预留度数设计的术后视力主视眼远视力及最佳矫正远视力、双眼合视远视力均无显著差异;33cm近视力和最佳矫正近视力主视眼和非主视眼差异均有统计学意义,双眼合视的近视力差异有统计学意义.可调节人工晶状体在自身调节能力基础上设计预留一定的度数,可明显改善近视力视功能.     

非球面优化单眼视准分子激光手术治疗近视合并老视的应用

目的:探讨非球面优化单眼视准分子激光手术治疗老视的安全性、有效性及视觉质量。方法:前瞻性临床研究。收集2018年1─12月在柳州市工人医院视光科行非球面优化单眼视准分子激光手术患者50例(100眼),术后1周、1个月、3个月、6个月随访观察患者远近距离裸眼视力、电脑验光、角膜地形图、角膜Q值、球差、对比敏感度、立体视锐度等,并使用屈光矫正者生命质量量表(QIRC)评估手术对生存质量的影响。采用 t检验、重复测量的方差分析进行数据分析。 结果:术前双眼各项指标基本匹配,术后6个月主视眼logMAR远视力达0.0的患者有94%,非主视眼logMAR近视力均达到0.5,96%的患者达到0.3。主视眼术后6个月Q值与非主视眼相比,差异有统计学意义( t=2.142, P=0.03)。等效球镜度(SE)、Q值与球差呈正相关( r=0.496, P<0.001;r=0.197, P=0.05)。患者双眼术后1周对比敏感度在各空间频率均低于术前,术后6个月除18 cpd以外,均达到术前水平(均 P<0.05)。大部分患者反映视觉质量良好;2例诉夜间眩光、重影。患者术后6个月立体视与术前相比差异无统计学意义。 结论:非球面优化单眼视准分子激光手术治疗近视合并老视是安全有效的,且不损害视觉质量。     

LaserACE激光巩膜手术矫正老视

目的评价LaserACE激光巩膜手术矫正老视术后12个月的临床效果。方法回顾性病例研究。纳入老视患者8例（16眼）,进行LaserACE激光巩膜矫正手术。术后1、3、6、12个月复查,测量远中近距离视力、近附加、阅读速度、眼压（IOP）和等效球镜度（SE）,并通过Catquest-9SF问卷评估患者主观感受。采用重复测量方差分析和配对t检验对数据进行处理。结果术后均无明显并发症,无最佳矫正远视力丢失者。术后1、3、6、12个月双眼及单眼近距离视力较术前相比明显提高,差异有统计学意义（F=10.79、26.64,P<0.01）。手术前后各时间点双眼及单眼中距离视力差异有统计学意义（F=5.11、8.10,P<0.05）,但术后12个月双眼中距离视力与术前差异无统计学意义。手术前后双眼及单眼远视力差异无统计学意义。术后近附加较术前下降（F=69.79,P<0.01）;平均阅读速度较术前均有显著提高（F=11.27,P<0.01）。手术前后IOP、SE无显著改变。结论LaserACE激光巩膜气化手术是安全的,术后12个月内患者近、中距离视力提高,且远视力不受影响。     

Conductive keratoplasty for presbyopia: 3-year results

PURPOSE: To assess the long-term safety, efficacy, and stability of conductive keratoplasty (CK) in the treatment of presbyopia. METHODS: Ten near-plano presbyopic patients (6 women and 4 men) underwent unilateral CK with standard-pressure technique in the non-dominant eye to improve their near vision. Mean age was 51+/-3.1 years (range: 46 to 56 years). Nine of the 10 patients were available for both 1- and 3-year follow-up examinations. RESULTS: Preoperative mean manifest refraction spherical equivalent (MRSE) was -0.17+/-0.29 diopters (D), yielding a mean near uncorrected visual acuity (UCVA) of J10. Three years after CK, the mean near UCVA was J3. The mean MRSE at 3 years was -1.06+/-0.81 D, which represents a 0.25 D change from the MRSE at 1 year. The MRSE in the dominant untreated eyes had a +0.26 D change during the 3-year period, which was not statistically different when compared to the CK-treated eyes during the 3-year postoperative period. No eye lost best spectacle-corrected visual acuity or had induced cylinder > or =0.75 D. Seventy-eight percent had binocular distance UCVA 20/20 or better and near UCVA J3 or better. The average keratometry remained stable at 45.09 D 3 years postoperatively compared to 45.08 D 1 year postoperatively. CONCLUSIONS: Conductive keratoplasty for the treatment of presbyopia provided safe, effective, predictable, and stable results 3 years following the initial surgery. Refractive stability was similar for both the CK-treated and untreated eyes with a small hyperopic shift noted during the 3-year follow-up period.     

Q值优化Micro-Monovision矫正近视合并老视的短期临床效果

探讨Q值优化Micro-monovision准分子激光手术矫正近视合并老视的安全性、有效性及预测性。方法：前瞻性临床研究。收集2017 年8 月至2018 年5 月在青岛大学附属医院行Q值优化Micro-monovision准分子激光手术的近视合并老视患者35例（70眼）。术后3个月观察单眼和双眼的远、近视力（logMAR视力）、屈光状态、对比敏感度（CS）及立体视，并进行近距离工作视觉疲劳问卷及满意度调查。采用配对t检验对手术前后数据进行分析。结果：35例患者术前双眼视远最佳矫正视力（BCVA）为0.01±0.06，术后3个月为-0.04±0.21，且术后无一眼BCVA下降1行及以上。术后主视眼裸眼视力（UCVA）为-0.04±0.19，非主视眼UCVA为0.04±0.13。所有患者主视眼视近UCVA 均达20/25及以上，非主视眼均达20/20。所有术眼实际获得等效球镜度（SE）与预期切削SE的差值均在±1.00 D以内，而差值在±0.50 D以内为60眼（86%）。术后3个月CS在昼+周边眩光条件下18.0 c/d频段较术前显著提高（t=-2.504，P=0.017）；在昼1.5、6.0、18.0 c/d频段，昼+周边眩光6 c/d频段，夜1.5 c/d频段，夜+周边眩光18.0 c/d频段CS均较术前显著下降（P<0.05），其他各条件频段CS均恢复至术前水平。立体视术后3个月与术前比较差异均无统计学意义。所有患者术后均未出现近距离工作后头痛、恶心、阅读模糊及视近困难。所有患者对手术效果均表示满意，满意度为100%。结论：Q值优化Micro-monovision准分子激光手术矫正近视合并老视，可同时获得较好的双眼远、近视力及双眼视功能，是一种安全、有效且预测性好的手术方法。     

Subjective and objective outcome following implantation of the apodized diffractive AcrySof ReSTOR

BACKGROUND: Our purpose in this study was to assess the postoperative subjective and objective results after implantation of the Acrysof ReSTOR lens and to evaluate the advantages and limitations of the apodized diffractive optic design of this new multifocal intraocular lens (MIOL). METHODS: Phakoemulsification and implantation of an Acrysof ReSTOR was performed in 55 eyes of 32 patients. All patients were examined after a mean period of 7.9+/-1.9 months. The accuracy of lens calculation was evaluated for the Haigis, Holladay I, and SRK-T formulas. Uncorrected and corrected visual acuity for distance and for intermediate and near vision were assessed, as was stereoacuity. In addition, contrast sensitivity was tested under photopic and mesopic conditions, with and without glare. The patients were asked about dysphotic phenomena such as halos, glare or flare, and night vision using a standardized evaluation. The degree to which patients were able to manage without spectacles after the surgery was also documented. RESULTS: The median monocular uncorrected visual acuity (UCVA) for distance was 20/25 (LogMAR 0.05) while the binocular UCVA was 20/20 (LogMAR 0). The monocular uncorrected acuity for near vision was 20/25 (LogMAR 0.1), the binocular near visual acuitiy was 20/20 (LogMAR 0), while the intermediate monocular visual acuity was 20/50 (LogMAR 0.4) and the binocular, 20/32 (LogMAR 0.2). Contrast sensitivity was within the normal range. Dysphotic phenomena were noted by 66% of patients but were so slight as not to cause any problem at all in 59%. For close work and distance vision 84% of all patients needed no correcting glasses, while 78% did not need to use glasses for intermediate vision. CONCLUSION: The Acrysof ReSTOR provides excellent uncorrected visual acuity for distance and near vision and the level of patient satisfaction achieved with it is good.     

Correction of presbyopia in hyperopia with a center-distance, paracentral-near technique using the Technolas 217z platform

PURPOSE: To analyze the results of hyperopic patients treated with a peripheral presbyLASIK algorithm for the correction of presbyopia. METHODS: The study included 44 eyes of 22 hyperopic patients treated with a peripheral presbyLASIK technique using a Technolas 217z excimer laser. Mean patient age was 56 years (range: 47 to 72 years), mean preoperative spherical equivalent refraction was +1.21 +/- 0.77 diopters (D) (range: +0.50 to +4.00 D), and mean spectacle near addition was +1.76 +/- 0.42 D (range: +1.00 to +2.75 D). The Peripheral Multifocal LASIK (PML) ablation pattern creates a multifocal corneal profile over a 6.5-mm diameter, performing the distance correction first in a 6-mm optical zone and then near correction in a 6.5-mm zone. Main outcome measures were uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) for near and distance, spherical equivalent refraction, contrast sensitivity, and corneal aberrations. RESULTS: Six months postoperatively, mean binocular UCVA was 1.06 +/- 0.13 for distance and 0.84 +/- 0.14 for near. Mean postoperative spherical equivalent refraction was -0.42 D (range: -1.12 to +0.87 D). Two (4.5%) eyes lost 1 line of BSCVA for distance and near vision, and 20 (45%) eyes gained 1 line of distance BSCVA. Contrast sensitivity decreased for 3, 6, 12, and 18 cycles/degree. Corneal aberration analysis showed a slight increase in coma and decrease in spherical aberration. CONCLUSIONS: The peripheral presbyLASIK technique used in this study is a safe and efficient treatment that may improve functional near vision in presbyopic patients with low and moderate hyperopia (from +0.50 to +3.00 D).     

白内障人工晶状体植入术后多维立体视评估

目的 比较双眼白内障患者单眼及双眼不同类型人工晶状体（IOL）植入术后多维立体视的变化。方法 回顾性分析双眼白内障摘出联合IOL植入术患者的数据。比较不同类型IOL植入术后各阶立体视的差异,并比较单眼术后和双眼术后各阶立体视的变化。对影响各阶立体视的因素进行Logistic回归分析。结果 双眼白内障患者在行双眼手术后比单眼手术后各阶立体视均有改善,差异具有统计学意义。单眼术后立体视与患者年龄和双眼间最佳矫正视力（BCVA）差相关,年龄越小、双眼间BCVA差值越小,则立体视越好。IOL的不同类型对立体视无显著影响。结论 不同类型IOL植入术后均可获得良好的立体视,且差异无统计学意义。由于不同患者对立体视的需求不同,在单眼术后可依据双眼BCVA差值选择另眼手术的时机。     

Conductive keratoplasty for presbyopia: 1-year results

PURPOSE: To assess the safety, efficacy, and stability of conductive keratoplasty (CK) in the treatment of presbyopia. METHODS: Ten near plano presbyopic patients (6 women and 4 men) underwent unilateral CK in the non-dominant eye to improve their near vision. Mean age was 51 +/- 3.1 years (range: 46 to 56 years). The surgeries were the author's first 10 CK procedures performed. The postoperative target for these eyes ranged from -1.25 to -1.75 diopters (D). RESULTS: Preoperative mean manifest refraction spherical equivalent (MRSE) was -0.18 +/- 0.27 D (range: -0.75 to -0.25 D), yielding a mean near uncorrected visual acuity (UCVA) of J10 (range: J12 to J5). Twelve months after CK, the mean near UCVA was J1 (range: J3 to J1) with 90% (9/10) eyes J1 and 100% (10/10) eyes J3 or better. The mean MRSE was -1.31 +/- 0.53 D (range: -2.25 to -0.75 D). Treated eyes lost an average of 2.2 +/- 2 lines (range: 0 to 5) of distance UCVA but gained an average of 8.7 +/- 2 lines (range: 4 to 11) of near UCVA. No eye lost best spectacle-corrected visual acuity or had induced cylinder > or = 0.75 D. Nine (90%) of 10 patients had binocular distance UCVA < or = 20/20 and near UCVA < or = J1 and all 10 (100%) patients had binocular distance UCVA < or = 20/25 and near UCVA < or = J3. CONCLUSIONS: Conductive keratoplasty for the treatment of presbyopia provided safe and effective results 1 year following the initial surgery. Longer follow-up will be needed to describe refractive stability. The mean near and distance UCVA results were better than expected for the amount of refractive change observed during this study.     

Subjektive und objektive Ergebnisse nach Implantation der apodisiert diffraktiven AcrySof ReSTOR

Background

Our purpose in this study was to assess the postoperative subjective and objective results after implantation of the Acrysof ReSTOR lens and to evaluate the advantages and limitations of the apodized diffractive optic design of this new multifocal intraocular lens (MIOL).

Methods

Phakoemulsification and implantation of an Acrysof ReSTOR was performed in 55 eyes of 32 patients. All patients were examined after a mean period of 7.9±1.9 months. The accuracy of lens calculation was evaluated for the Haigis, Holladay I, and SRK-T formulas. Uncorrected and corrected visual acuity for distance and for intermediate and near vision were assessed, as was stereoacuity. In addition, contrast sensitivity was tested under photopic and mesopic conditions, with and without glare. The patients were asked about dysphotic phenomena such as halos, glare or flare, and night vision using a standardized evaluation. The degree to which patients were able to manage without spectacles after the surgery was also documented.

Results

The median monocular uncorrected visual acuity (UCVA) for distance was 20/25 (LogMAR 0.05) while the binocular UCVA was 20/20 (LogMAR 0). The monocular uncorrected acuity for near vision was 20/25 (LogMAR 0.1), the binocular near visual acuitiy was 20/20 (LogMAR 0), while the intermediate monocular visual acuity was 20/50 (LogMAR 0.4) and the binocular, 20/32 (LogMAR 0.2). Contrast sensitivity was within the normal range. Dysphotic phenomena were noted by 66% of patients but were so slight as not to cause any problem at all in 59%. For close work and distance vision 84% of all patients needed no correcting glasses, while 78% did not need to use glasses for intermediate vision.

Conclusion

The Acrysof ReSTOR provides excellent uncorrected visual acuity for distance and near vision and the level of patient satisfaction achieved with it is good.