PURPOSE To evaluate the objective and subjective visual quality 3 months after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) performed with Q-value-guided optimized monovision scheme (Custom-Q) for correction of myopia with or without astigmatism and compensate for age-related accommodation deficiency. DESIGN Prospective before-and-after study. METHODS Patients who had Custom-Q FS-LASIK for myopia with age-related accommodation deficiency were included in this prospective study. Distance, intermediate, and near visual acuities; refraction; Q value; corneal higher-order aberrations (HOAs); accommodative and binocular function measurements; defocus curve; contrast sensitivity and a subjective questionnaire assessing near visual ability and visual discomforts were evaluated before and after surgery. RESULTS Clinical data of 48 cases were analyzed. The mean age was 42.73 ± 2.67 years (40 to 50 years). At the 3-month follow-up, there were 100% (48/48), 92% (44/48), and 56% (27/48) patients who achieved a binocular uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA) not less than 20/20 separately. Defocus curves revealed better results postoperatively at - 1.00 D and - 1.50 D. The Q value in the dominant eyes was more positive postoperatively (P<0.001), and in the non-dominant eyes, the Q value and corneal spherical aberration (SA) became more negative (P<0.05). The accommodative amplitude (AA) and relative accommodation improved binocularly (P<0.001). The questionnaire demonstrated high patient satisfaction with near vision, and patients' perceptions of visual discomforts had no significantly difference compare with preoperative. CONCLUSION For myopic patients with age-related accommodation deficiency, the Custom-Q ablation could improve near vision without compromising distance vision. It also led to minimal changes in objective optical quality, coordination of accommodative and binocular functions, contrast sensitivity, and subjective visual discomforts perceptions.

中文翻译：

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近视和老花眼患者 FS-LASIK 与 Q 值引导的优化单视后的视觉质量：Custom-Q 治疗近视和老花眼。


目的 评价飞秒激光辅助激光原位角膜磨镶术 （FS-LASIK） 术后 3 个月的客观和主观视觉质量，并使用 Q 值引导的优化单视方案 （Custom-Q） 矫正伴或不伴散光的近视并补偿与年龄相关的调节缺陷。设计 前瞻性前后研究。方法 本前瞻性研究纳入接受 Custom-Q FS-LASIK 治疗近视伴年龄相关调节缺陷的患者。远、中和近视力;折射;Q 值;角膜高阶像差 （HOA）;调节和双眼功能测量;散焦曲线;在手术前后评估对比敏感度和评估近视力和视觉不适的主观问卷。结果 分析 48 例患者的临床资料。平均年龄为 42.73 ± 2.67 岁 （40 至 50 岁）。在 3 个月的随访中，有 100% （48/48） 、 92% （44/48） 和 56% （27/48） 的患者达到双眼未矫正远、中和近视力 （UDVA、UIVA、UNVA） 分别不低于 20/20。离焦曲线显示术后 -1.00 D 和 -1.50 D 时效果更好。术后优势眼 Q 值更正 （P<0.001），非优势眼 Q 值和角膜球差 （SA） 更负 （P<0.05）。调节幅度 （AA） 和相对调节呈双眼改善 （P<0.001）。问卷显示患者对近视力的满意度高，患者对视觉不适的感知与术前相比无显著差异。 结论 对于年龄相关调节缺陷的近视患者，Custom-Q 消融术可以在不影响远视力的情况下改善近视力。它还导致客观光学质量、调节和双眼功能的协调、对比敏感度和主观视觉不适感知的最小变化。