An Initiai Study of Clinical Application of the Carl Zeiss Meditec Mel80Shotfile Software to Correct Presbyopia
|Keywords||Presbyopia the shotfile software visual quality laser in situkeratomileusis higher order aberrations|
Objective To compare clinical effect among the group of the shotfile for the correction of, Presbyopia,reserved group and full correction group and evaluate the clinical efficacy of the shotfile for the correction of PresbyopiaMethods77eyes of44patients with complete information were selected from January2009to August2011in the ophthalmology of the people’s Liberation Army150th hospital.All patients had an operation by TOSCA surgery and the shotfile software for the correction of presbyopia as the treatment group I. The patients aged from35to47years (38.5±2.7years) consist of23males and21females. There were5patients(10eyes) with hyperopic astigmatism and presbyopia,39patients(67eyes) with myopia astigmatism and presbyopia. The way:18eyes which were dominant eyes of the patients were recieved6.OB, non-dominant eyes were received6.0C;20eyes of10patients were recieved6.0B; lOeyes of5patients were recieved6.0C;7eyes of7patients were recieved6.0B;4eyes of4patients were recieved6.0C.The mean spherical equivalent was-12.12-+1.25D (-4.74±3.18D).Then58eyes of29patients who reserved with-0.50D as treatment group Ⅱ and17eyes of10patients didn’t reserved and received the treatment of presbyopia as the control group. There was no difference of age, equivalent spherical, uncorrected vision and BSCAV among the three groups. Then the postoperative distance vision and near vision, refraction, higher order aberration, contrast sensitivity, stereo vision,treatment of topography and satisfaction were compared among the three groups.Results1.The postoperative distance vision of the treatment groupl, the treatment group Ⅱand the control group.at6months after operation were:1.00±0.16,0.90±0.14,1.02±0.17. The postoperative distance vision were higher than preoperative,it was statistically different (P<0.05). It was no statistically difference for distance vision at6 months after operation among the three groups (P>0.05). The near vision at6months after operation of the treatment group I, the treatment group Ⅱ and the control group. were1.07±0.29,0.90±0.31and0.79±0.23. The near vision of the treatment group I was better than that of the control group,and it was ststistically different (t=3.786,P<0.05). There were no ststistically different between the treatment group land the treatment group II,,2. Diopter: The spherical equivalent at6months after operation of the three groups were separately:-0.41±0.56D、-0.49±0.39D、-0.38±0.34D. The postoperative mean spherical equivalent was lower than the preoperative,it was statically different (P<0.05). The postoperative diopter was within±0.50D at different times. There was no significant difference at the different times (P>0.05) and there was no ststistically difference among the groups.3. Higher order aberrations:When the pupil diameter was6mm, there was an statistically difference in the vertical coma and spherical aberration between the preoperative and the postoperative at6months (P<0.05).The spherical aberration and horizontal coma in the treatment groupIwere higher than that in the treatment group Ⅱ and the control group, it was statistically diferent (P<0.05). There was no difference of the total higher order aberrations and the vertical coma among the three groups.4. The contrast sensitivity:There was no difference among low, medium, high frequency contrast sensitivity at different times (P>0.05); The low, medium and high frequency contrast sensitivity were decreased after10days and1month and it returned to the preoperative level at3months after oPeration.5.Stereo vision:There was no significant difference between the preoperative and postoperative (P>0.05).There was no significant difference among the three groups at6months after operation (P>0.05).6.Treatment of topography: The CIM in the treatment groupIwere higher than that in the treatment group Ⅱ, it was statistically diferent (P<0.05).7. Satisfaction:Three groups satisfied with the percentage of near vision were:86.4%,59.5%,40%; More satisfied were9%,20.7%,24.1%;The disaffection were40%,20%,24.1%.8.The operative and postoperative complication: There was no operative or postoperative serious complications such as corneal irregularity, free corneal flap, small corneal flap and implantation of corneal.Conclusions:1. We found that the shotfile software was a well-tolerated and effective procedure for treating patients with presbyopia,and it can effectively improve the near vision without loss of distance vision in early period.2. The shotfile software for the correction of presbyopia can effectively increase the corneal spherical aberration and compensate for the regulation ability of presbyopia patients so as to achieve better effection of the distance vision and near vision.Simultaneity more horizontal coma and vertical coma was introduced after the shotfile software for the correction of presbyopia.The long-term effect needs further study.3.The postoperative contrast sensitivity fell at the early stage and return to the preoperative level after3months.4. There was no difference between the preoperative and postoperative stereo vision.The effect was better than the MV.