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目的:探讨传导性角膜热成形术(CK)治疗超声乳化联合单焦点人工晶状体植入术后老视的安全性和有效性。方法:15例双眼超声乳化联合单焦点人工晶状体植入术后老视症状明显的正视或轻度近视的非主视眼行CK治疗,分别于术前1天、术后1周、1个月、3个月和6个月行双眼裸眼近视力、远视力、最佳矫正远视力、最佳矫正近视力、显然验光等效球镜、泪膜破裂时间、泪液分泌试验。结果:CK术后6月双眼裸眼远视力≥0.8且近视力≥0.5(J3)或近视力≥0.33(J4)者分别为11例(73.3%),14例(93.3%);术后6月术眼散光度在±1.00(DC)以内者为86.7%;术后6个月15例非注视眼行CK术后裸眼远视力由(0.87±0.09)(DS)下降为(0.68±0.09)(DS),差异有统计学意义。术前平均角膜曲率(41.99±0.47)(D)增加至术后(43.64±0.59)(D),差异有统计学意义。术眼泪膜破裂时间术前(12.0±1.69)(s)缩短为术后(10.00±1.77)(s),差异有统计学意义。术后6个月13例(86.7%)患者表示满意,术后可以较长时间(>1h)阅读,可以不使用近用眼镜。结论:应用单眼视原理采用CK治疗超声乳化联合单焦点人工晶状体植入术后非主视眼老视,能够获得较好的双眼远、近视力,减少术后对眼镜的依赖。
Objective: To investigate the safety and efficacy of conduction keratomileusis (CK) in the treatment of presbyopia after phacoemulsification and monofocal intraocular lens implantation. Methods: Fifteen patients with non-dominant myopia with obvious myopia or mild myopia who underwent phacoemulsification combined with single-focus intraocular lens implantation were treated with CK, one day before surgery, one week after surgery, one month after surgery , 3 months and 6 months underwent open eye near vision, far vision, best corrected far vision, best corrected near vision, apparently optometry equivalent spherical, tear film rupture time, tear secretion test. Results: In 11 eyes (73.3%) and 14 eyes (93.3%), the uncorrected visual acuity of eyes ≥ 0.8 and the near vision ≥ 0.5 (J3) or near vision ≥ 0.33 (J4) Visual acuity was within ± 1.00 (DC) in 86.7% of eyes. The distance from the open eyes of 15 non-iris eyes at 6 months after operation was significantly decreased from (0.87 ± 0.09) (DS) to (0.68 ± 0.09) DS), the difference was statistically significant. The average preoperative corneal curvature (41.99 ± 0.47) (D) increased to postoperative (43.64 ± 0.59) (D), the difference was statistically significant. The preoperative tear film rupture time was (12.0 ± 1.69) s (s) shortened to (10.00 ± 1.77) s postoperatively, the difference was statistically significant. 13 cases (86.7%) were satisfied at 6 months after operation, and could read for a long time (> 1h) after operation. CONCLUSIONS: Using monocular visual theory to treat the non-dominant presbyopia after phacoemulsification combined with single-focus intraocular lens implantation by CK, we can get better binocular distance and near visual acuity and reduce the postoperative dependence on the glasses.