Purpose:

To evaluate clinical outcomes and visual quality 12 months after femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) performed with the Custom-Q algorithm for correction of myopia with or without astigmatism and compensate for age-related accommodation deficiency.

Methods:

Patients who had Custom-Q FS-LASIK for myopia and myopic astigmatism with age-related accommodation deficiency were included in this retrospective study. Distance, intermediate, and near visual acuities, objective and subjective refractions, Q-factor, corneal higher order aberrations (HOAs), accommodation function, defocus curve, contrast sensitivity, and a subjective questionnaire assessing visual quality were evaluated 12 months postoperatively.

Results:

Clinical data of 43 cases were analyzed. The mean age was 42.02 ± 1.85 years (range: 40 to 48 years). At the 12-month follow-up visit, there were 43 (100%), 42 (97%), and 33 (77%) patients who achieved a binocular uncorrected distance, intermediate, and near visual acuity, respectively, better than 20/20 separately. Defocus curves revealed better distance vision in the dominant eyes, and the nondominant eyes performed better at intermediate and near vergence (P < .001). The Q-value and corneal spherical aberration coefficient were more positive in the dominant eyes than those in the nondominant eyes (P < .001). The accommodative amplitude and relative accommodation improved binocularly (P < .001). The questionnaire demonstrated high patient satisfaction with near vision, and no one reported having severe visual disturbance.

Conclusions:

For myopic patients with age-related accommodation deficiency, the Custom-Q algorithm proved to be an effective way to achieve acceptable near vision without compromising distance vision.

[J Refract Surg. 2024;40(4):e245–e252.]

目的：

旨在评估使用 Custom-Q 算法进行飞秒激光辅助激光原位角膜磨镶术 (FS-LASIK) 12 个月后的临床结果和视觉质量，以矫正伴有或不伴有散光的近视并补偿与年龄相关的调节缺陷。

方法：

这项回顾性研究纳入了接受 Custom-Q FS-LASIK 治疗近视和近视散光并伴有年龄相关调节缺陷的患者。术后12个月评估远视力、中视力、近视力、客观和主观屈光度、Q因子、角膜高阶像差（HOA）、调节功能、散焦曲线、对比敏感度以及评估视觉质量的主观问卷。

结果：

对43例患者的临床资料进行分析。平均年龄为 42.02 ± 1.85 岁（范围：40 至 48 岁）。在 12 个月的随访中，分别有 43 名（100%）、42 名（97%）和 33 名（77%）患者的双眼未矫正远视力、中视力和近视力优于 20 /20 分开。散焦曲线显示优势眼的远视力更好，非优势眼在中间和近处的聚散度表现更好（P < .001）。主视眼的 Q 值和角膜球差系数比非主视眼的 Q 值和角膜球差系数更显着 ( P < .001)。双眼调节幅度和相对调节有所改善 ( P < .001)。调查问卷显示患者对近视力的满意度很高，并且没有人报告有严重的视力障碍。

结论：

对于与年龄相关的调节不足的近视患者，Custom-Q 算法被证明是在不影响远视力的情况下实现可接受的近视力的有效方法。

[屈光外科杂志。 2024；40(4)：e245–e252。]