AIM: To evaluate the clinical efficacy of the treatment for patients with presbyopia by Shotfile software.

METHODS: Seventy-seven eyes of 44 patients with complete information received the operation by the TOSCA surgery and the Shotfile software for the correction of presbyopia. The distance and near vision(dominant eye, non-dominant eye, binocular), refraction, higher order aberration, contrast sensitivity and stereo vision were compared between the preoperative and postoperative. The degree of the postoperative satisfaction was investigated.

RESULTS: The average distance vision of dominant eyes 6 months after operation were 1.00±0.16; and non-dominant eyes were 1.00±0.23. The average near vision of dominant 6 months after operation were 1.07±0.29; and non-dominant eyes were 1.09±0.33. The average spherical equivalent 6 months after operation were -0.41±0.56D. The postoperative mean spherical equivalent was lower than the preoperative, which was statically different(P<0.05). With the 6mm pupil diameter, the preoperative total higher order aberrations, horizontal coma, vertical coma and spherical aberration were: 0.573±0.308, -0.025±0.173, -0.025±0.110, 0.174±0.133; the total higher order aberrations, horizontal coma, vertical coma, spherical aberration 6 months after operation were 0.594±0.247, -0.090±0.212, -0.272±0.195 and 0.297±0.146. There was statistically difference in the vertical coma and spherical aberration between the preoperative and the postoperative 6 months(P<0.05). The low, medium and high frequency contrast sensitivity were decreased after 10 days and 1 month and it returned to the preoperative level 3 months after operation. There was no significant difference between the preoperative and postoperative stereo vision(P>0.05). 38 patients(86.4%)were satisfied with the effect of surgery; 4 patients(9.1%)relatively were satisfied with the effect of surgery; 2 patients(4.5%)were not satisfied with the near vision after operation. There were no operative or postoperative serious complications.

CONCLUSION: We found that the Shotfile software was a well-tolerated and effective procedure for treating patients with prisbyopia, and it can effectively improve the near vision without loss of distance vision in early period. The increasing spherical aberration can compensate for the depression of lens regulation ability in patients with presbyopia. While the increase of horizontal coma and vertical coma, it may lead to a decline of visual quality. There was no difference between the preoperative and postoperative stereo vision.