AIM： To assess the loss of contrast sensitivity （CS） function for INTRACOR or intrastromal femtosecond laser presbyopia procedure to conventional LASIK procedures.METHODS： Patients were recruited from a refractive...AIM： To assess the loss of contrast sensitivity （CS） function for INTRACOR or intrastromal femtosecond laser presbyopia procedure to conventional LASIK procedures.METHODS： Patients were recruited from a refractive surgery center for either INTRACOR or conventional LASIK. INTRACOR was performed on 8 eyes and LASIK was performed for 40 eyes in an overlapping period. Pre-operative evaluation and post-operative follow up for up to three months was done. Drops of CS in 4 spatial frequency （3 cpd, 6 cpd, 12 cpd and 18 cpd） right before and 3mo after the surgery were compared by Wilcoxon signed ranks test.RESULTS： For INTRACOR, CS threshold showed significant drop at both glare and non-glare condition, the drop was seen in all 4 spatial frequency. The averaged loss over the 4 spatial frequencies 3mo after surgery was 1.18 for non-glare and 0.71 for glare. For LASIK the CS threshold drop was most significant in 12 cpd for glare.CONCLUSION： INTRACOR procedure produces a gain of near vision for presbyopia patients but also introduces a high lost of contrast sensitivity plus worsen of vision quality. Pre-surgical patient selection and advise should be given with specific regards to night driving and glare conditions.展开更多
Purpose:The aim of this systematic review was to synthesize and appraise the evidence of the benefits of presbyopic correction on the cornea for visual function.Summary:Comprehensive search was conducted in MEDLINE us...Purpose:The aim of this systematic review was to synthesize and appraise the evidence of the benefits of presbyopic correction on the cornea for visual function.Summary:Comprehensive search was conducted in MEDLINE using keywords like“presbylasik”,“presbyopic refractive surgery”,“corneal pseudoaccommodation”and“corneal multifocality”.We reviewed corrected and uncorrected visual acuities for distance and near(uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),corrected distance visual acuity(CDVA),distance corrected near visual acuity(DCNVA),corrected near visual acuity(CNVA)),along with the refractive outcomes in spherical equivalent(SE)and astigmatism comparing the differences observed between preoperative myopic and hyperopic patients,as well as among techniques.Thirty-one studies met the inclusion and quality criteria.Monovision provides excellent distance and near uncorrected acuities,but with a 17%retreatment and a 5%reversal rate.Initial multifocal ablations result in 12%loss of 2 or more lines of CDVA,and a 21%retreatment rate.Laser Blended Vision provides excellent UDVA,but with a 19%retreatment rate.Initial experiences with Supracor show moderate predictability and a 22%retreatment rate.Intracor results in 9%loss of 2 or more lines of CDVA.KAMRA provides excellent UDVA,with only a 1%retreatment rate,but a 6%reversal rate.Initial experiences with PresbyMAX provided excellent UNVA and DCNVA,showing excellent predictability and a 1%reversal rate.Conclusions:The findings have implications for clinicians and policymakers in the health-care industry and emphasize the need for additional trials examining this important and widely performed clinical procedure.展开更多
文摘AIM： To assess the loss of contrast sensitivity （CS） function for INTRACOR or intrastromal femtosecond laser presbyopia procedure to conventional LASIK procedures.METHODS： Patients were recruited from a refractive surgery center for either INTRACOR or conventional LASIK. INTRACOR was performed on 8 eyes and LASIK was performed for 40 eyes in an overlapping period. Pre-operative evaluation and post-operative follow up for up to three months was done. Drops of CS in 4 spatial frequency （3 cpd, 6 cpd, 12 cpd and 18 cpd） right before and 3mo after the surgery were compared by Wilcoxon signed ranks test.RESULTS： For INTRACOR, CS threshold showed significant drop at both glare and non-glare condition, the drop was seen in all 4 spatial frequency. The averaged loss over the 4 spatial frequencies 3mo after surgery was 1.18 for non-glare and 0.71 for glare. For LASIK the CS threshold drop was most significant in 12 cpd for glare.CONCLUSION： INTRACOR procedure produces a gain of near vision for presbyopia patients but also introduces a high lost of contrast sensitivity plus worsen of vision quality. Pre-surgical patient selection and advise should be given with specific regards to night driving and glare conditions.
文摘Purpose:The aim of this systematic review was to synthesize and appraise the evidence of the benefits of presbyopic correction on the cornea for visual function.Summary:Comprehensive search was conducted in MEDLINE using keywords like“presbylasik”,“presbyopic refractive surgery”,“corneal pseudoaccommodation”and“corneal multifocality”.We reviewed corrected and uncorrected visual acuities for distance and near(uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),corrected distance visual acuity(CDVA),distance corrected near visual acuity(DCNVA),corrected near visual acuity(CNVA)),along with the refractive outcomes in spherical equivalent(SE)and astigmatism comparing the differences observed between preoperative myopic and hyperopic patients,as well as among techniques.Thirty-one studies met the inclusion and quality criteria.Monovision provides excellent distance and near uncorrected acuities,but with a 17%retreatment and a 5%reversal rate.Initial multifocal ablations result in 12%loss of 2 or more lines of CDVA,and a 21%retreatment rate.Laser Blended Vision provides excellent UDVA,but with a 19%retreatment rate.Initial experiences with Supracor show moderate predictability and a 22%retreatment rate.Intracor results in 9%loss of 2 or more lines of CDVA.KAMRA provides excellent UDVA,with only a 1%retreatment rate,but a 6%reversal rate.Initial experiences with PresbyMAX provided excellent UNVA and DCNVA,showing excellent predictability and a 1%reversal rate.Conclusions:The findings have implications for clinicians and policymakers in the health-care industry and emphasize the need for additional trials examining this important and widely performed clinical procedure.
