飞秒激光辅助与常规白内障超声乳化手术的临床疗效比较

doi:DOI:10.3760/cma.j.issn.1674-845X.2016.11.002

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摘要

目的比较飞秒激光辅助白内障超声乳化手术与常规白内障超声乳化手术的临床疗效。

方法前瞻性队列研究。根据患者意愿将212例（212眼）患者分为2组，行常规白内障超声乳化手术的为常规组112例（112眼），行飞秒激光辅助白内障超声乳化手术的为飞秒组100例（100眼）。记录术中累积超声乳化能量（CDE）、超声乳化时间（UST），术中及术后并发症，比较2组间术后1 d、1周、1个月、3个月的视力、眼压（IOP）、中央角膜厚度（CCT）、角膜内皮细胞计数及房水闪辉值。2组间数据比较采用独立样本t检验，对不同时间点数据比较采用重复测量方差分析。结果术中飞秒组的CDE、UST分别较常规组低49.5%、41.6%（t=13.24、16.88，P<0.01）。2组患者术后最佳矫正视力（BCVA）、IOP差异无统计学意义。飞秒组术后1 d、1周、1个月及3个月房水闪辉值均低于常规组（t=8.95、10.47、8.65、4.58，P<0.01），而角膜内皮细胞计数高于常规组（t=-4.28、-3.98、-4.19、-4.78，P<0.01）。术后1 d飞秒组CCT显著低于常规组（t=12.44，P<0.01）。飞秒组术后并发症主要为瞳孔缩小15眼（占15%）及结膜下出血36眼（占36%）。结论飞秒激光辅助白内障超声乳化手术较常规白内障超声乳化手术有效减少了术中CDE及UST，减轻了术后炎症反应，降低了角膜内皮细胞丢失率。

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	陈卉
	陈婉
	向武
	张波
	李静
	陈伟蓉
	刘奕志

关键词 ：白内障, 超声乳化白内障吸除术, 治疗结果, 飞秒激光

Abstract：

Objective To compare the clinical effects of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (PCS). Methods A prospective nonrandomized parallel cohort study of 212 patients (212 eyes) who underwent cataract surgery were divided into two groups based on the treatment protocol: PCS (112 patients, 112 eyes) and FLACS (100 patients, 100 eyes). The aim of this project was to compare the ultrasound time (UST), cumulative dissipated energy (CDE), and 1 day, 1 week, 1 month and 3 months postoperatively with best corrected visual acuity (BCVA), intraocular pressure (IOP), aqueous flare, central corneal thickness (CCT), endothelial cell density (ECD), and intraoperative and postoperative complications. The data were compared statistically using a t-test and repeated measures ANOVA． Results The CDE and UST of the FLACS group were reduced by 49.5% and 41.6%, respectively (t=13.24, 16.88, P<0.01). There were no statistically significant differences in IOP or BCVA between the two groups after surgery (P>0.05). Postoperative aqueous flare was significantly lower in the FLACS at all time points (t=8.95, 10.47, 8.65, 4.58, all P<0.01) and ECD was significantly higher in the FLACS group (t=-4.28, -3.98, -4.19, -4.78, all P<0.01). CCT was significantly lower in the FLACS group on postoperative day 1 (t=12.44, P<0.01). The main complications in the FLACS group included pupillary constriction (15%) and subconjunctival hemorrhage (36%). Conclusion Femtosecond laser-assisted cataract surgery results in significantly lower CDE and UST. It also reduces the severity of postoperative inflammation and corneal endothelial cell loss.

Key words： Cataract Phacoemulsification Therapy outcome Femtosecond laser

收稿日期: 2015-10-31

基金资助:

国家自然科学基金（81300784）；广东省科技计划项目（2013B021800054）

通信作者: 陈伟蓉，Email：chenwr_q@aliyun.com

引用本文:

陈卉,陈婉,向武,等. 飞秒激光辅助与常规白内障超声乳化手术的临床疗效比较. 中华眼视光学与视觉科学杂志, 2016, 18(11):645-649. DOI:DOI:10.3760/cma.j.issn.1674-845X.2016.11.002.
Chen Hui,Chen Wan,Xiang Wu,et al. Comparative study on the clinical effects of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2016, 18(11):645-649.

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