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飞秒激光白内障手术对黄斑的影响。

Effect of femtosecond laser cataract surgery on the macula.

机构信息

Department of Ophthalmology, Semmelweis University, Budapest, Hungary.

出版信息

J Refract Surg. 2011 Oct;27(10):717-22. doi: 10.3928/1081597X-20110825-01. Epub 2011 Aug 31.

Abstract

PURPOSE

To compare the effect of conventional and femtosecond laser-assisted (Alcon LenSx Inc) phacoemulsification on the macula using optical coherence tomography (OCT).

METHODS

Twenty eyes of 20 patients underwent uneventful cataract surgery in both study groups: femtosecond laser-assisted (laser group) and conventional phacoemulsification (control group). Macular thickness and volume were evaluated by OCT preoperatively and 1 week and 1 month postoperatively. Primary outcomes were OCT retinal thickness in 3 macular areas and total macular volume at 1 week and 1 month postoperative. Secondary outcomes were changes in retinal thickness at 1 week and 1 month postoperatively, with respect to preoperative retinal thickness values and effective phacoemulsification time.

RESULTS

Multivariable modeling of the effect of surgery on postoperative macular thickness showed significantly lower macular thickness in the inner retinal ring in the laser group after adjusting for age and preoperative thickness across the time course (P=.002). In the control group, the inner macular ring was significantly thicker at 1 week (mean: 21.68 μm; 95% confidence limit [CL]: 11.93-31.44 μm, P<.001). After 1 month, this difference decreased to a mean of 17.56 μm (95% CL: -3.21-38.32 μm, P=.09) and became marginally significant.

CONCLUSIONS

Results of this study suggest that femtosecond laser-assisted cataract extraction does not differ in postoperative macular thickness as compared with standard ultrasound phacoemulsification.

摘要

目的

利用光学相干断层扫描(OCT)比较传统和飞秒激光辅助(爱尔康 LenSx 公司)白内障超声乳化术对黄斑的影响。

方法

20 例(20 只眼)患者分别接受了无并发症的白内障手术,在研究组中,使用飞秒激光辅助(激光组)和传统的超声乳化术(对照组)。术前及术后 1 周和 1 个月,采用 OCT 评估黄斑厚度和体积。主要结果是术后 1 周和 1 个月 OCT 视网膜厚度在 3 个黄斑区和总黄斑体积。次要结果是术后 1 周和 1 个月视网膜厚度的变化,相对于术前视网膜厚度值和有效超声乳化时间。

结果

多变量模型显示,在调整了年龄和术前厚度后,手术后黄斑内视网膜环的黄斑厚度在激光组中显著降低(P=.002)。在对照组中,黄斑内环在术后 1 周显著增厚(平均:21.68 μm;95%置信区间[CL]:11.93-31.44 μm,P<.001)。1 个月后,这种差异缩小到平均 17.56 μm(95% CL:-3.21-38.32 μm,P=.09),且具有边缘显著性。

结论

这项研究的结果表明,飞秒激光辅助白内障摘出术与标准超声乳化术相比,术后黄斑厚度无差异。

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