方法：对104例186眼大龄近视患者(年龄≥40岁)采用Monovision矫正方法设计并进行LASIK手术，并对术前后视力、屈光度、手术疗效等进行统计分析。

结果：术后1mo，所有术眼的裸眼视力均明显提高(P<0.01)，达到1.0的百分率分别为非主导眼83.7%(87/104)，主导眼91.5%(75/82)； 术后裸眼视力与术前最佳矫正视力比较，非主导眼差异不显著(P>0.05)，而主导眼提高明显(P<0.01)； 术后屈光度非主导眼为-0.70±0.12D，与术前欠矫设计量基本一致(P>0.05)，主导眼为-0.04±0.28D，两组差异显著(P<0.01)； 患者对远视力满意度100%、近视力满意度82.7%。

结论：大龄近视患者行LASIK治疗以高度、超高度近视患者为主，大屈光参差(>2.50D)患者占比例较高； 采用Monovision矫正方法设计的LASIK术对改善大龄患者术后视近功能、缓解视疲劳以及提高其视觉满意度是切实有效的，将这一临床经验用于个体化手术方案的设计可以使其更为完善。

METHODS: Totally 104 myopic patients(186 eyes)with the age of 40 years or older were treated with LASIK. Monovision correction was chosen for all these patients. The preoperative refraction, refractive diopter supposed to be corrected, and the curative effects were analyzed.

RESULTS: The postoperative uncorrected visual acuity(UCVA)were improved significantly than of the preoperative in all 186 eyes after 1 month of operation(P<0.01). The postoperative UCVA ≥1.0 in 83.7% cases of nondominant eye(87/104)and 91.5% cases of dominant eye(75/82). The postoperative UCVA were better than preoperative best-corrected visual acuity(BCVA in most cases of dominant eye(P<0.01), and kept the same level in most cases of nondominant eye(P>0.05). The postoperative refraction of nondominant eyes was -0.70±0.12D, which share the same change with preoperative design -0.78±0.11D(P>0.05), but was higher than that of dominant eyes -0.04±0.28D(P<0.01). All the patients were satisfied with the postoperative far vision and 82.7% of the patients were satisfied with the postoperative near vision.

CONCLUSION: Most of 40 years of age or older patients treated with LASIK are high myopic or high myopic anisometropia patients; LASIK with monovision correction is safe and effective for older myopic patients. Actual corrective diopter may be reduced because of age-related presbyopia, and the far vision and near vision would be satisfactory postoperatively.