PURPOSE To compare varifocal (SupraCor; Technolas Perfect Vision GmbH, Munich, Germany) to monofocal (Zyoptix TissueSaving; Bausch & Lomb, Rochester, NY) LASIK in patients with hyperopic presbyopia. METHODS In this prospective, non-randomized, comparative case series, consecutive patients with hyperopia, presbyopia, and emmetropia as target refraction were bilaterally treated with varifocal (8 patients) or monofocal (7 patients) LASIK. The study was designed for 35 patients, but was terminated early after interim analysis. Outcomes (preoperative and 1 day, 1 week, 1 month, and 3 months postoperative) were: monocular and binocular uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), low-contrast UDVA and CDVA, efficacy, and safety. RESULTS Preoperative data were similar in both groups. Monocular and binocular UNVA were not significantly different between both groups at any follow-up visit. At 3 months, mean monocular UNVA was 0.40 logMAR in both groups. Monocular DCNVA and binocular CDVA were not significantly different between groups. Monocular mean CDVA was 0.00 ± 0.06 logMAR after varifocal LASIK and -0.06 ± 0.04 logMAR after monofocal LASIK. The efficacy index was 0.9 after vari-focal LASIK and 0.88 after monofocal LASIK (not significant). The safety index was 1.08 after varifocal LASIK and 1.125 after monofocal LASIK (not significant). CONCLUSIONS With emmetropia as target refraction, varifocal ablations yielded no additional benefit compared to monofocal ablations in hyperopic presbyopic LASIK. The authors speculate that epithelial remodeling masks the impact of a varifocal ablation pattern and that a myopic postoperative refraction (modified monovision) may be necessary to further improve near and intermediate vision. These results demonstrate the value of a control group in studies evaluating presbyopia corrections. [J Refract Surg. 2019;35(7):459-466.].

中文翻译：

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老花眼远视眼的变异性与单焦点性LASIK。

目的将远视老花眼患者的LASIK与单焦点（Zyoptix TissueSaving； Bausch＆Lomb，纽约州罗彻斯特）进行比较。方法在该前瞻性，非随机，比较病例系列中，连续性以远视，老花眼和正视为屈光目标的连续患者采用单焦点（8例）或单焦点（7例）LASIK进行双侧治疗。该研究针对35位患者而设计，但在中期分析后就被终止。结果（术前和术后1天，1周，1个月和3个月）为：单眼和双眼未矫正近视力（UNVA），距离矫正近视力（DCNVA），未矫正远视力（UDVA），矫正远视力（CDVA），低对比度UDVA和CDVA，疗效，和安全。结果两组的术前数据相似。在任何后续随访中，两组之间的单眼和双眼UNVA差异均无显着性。在3个月时，两组的平均单眼UNVA为0.40 logMAR。两组之间的单眼DCNVA和双眼CDVA没有显着差异。单眼LASIK术后单眼平均CDVA为0.00±0.06 logMAR，单眼LASIK术后单眼平均CDVA为-0.06±0.04 logMAR。变焦点LASIK术后疗效指数为0.9，单焦点LASIK术后疗效指数为0.88（无显着性）。变焦LASIK术后安全指数为1.08，单焦点LASIK术后安全指数为1.125（不显着）。结论以正视眼作为目标屈光度，与远视老花眼LASIK手术中的单焦点消融术相比，变焦消融术没有其他好处。作者推测，上皮重塑掩盖了变焦聚焦消融模式的影响，近视术后屈光（改良单视）可能是进一步改善近视和中视的必要条件。这些结果证明了对照组在评估老花眼矫正的研究中的价值。[J Refract Surg。2019; 35（7）：459-466。]。