Abell Robin G, Kerr Nathan M, Howie Allister R, Mustaffa Kamal Mohd A A, Allen Penelope L, Vote Brendan J
From Launceston Eye Institute (Kerr, Vote), Launceston, and Tasmanian Eye Institute (Abell, Howie, Mustaffa Kamal, Allen, Vote), Tasmania, Australia.
From Launceston Eye Institute (Kerr, Vote), Launceston, and Tasmanian Eye Institute (Abell, Howie, Mustaffa Kamal, Allen, Vote), Tasmania, Australia.
J Cataract Refract Surg. 2014 Nov;40(11):1777-83. doi: 10.1016/j.jcrs.2014.05.031. Epub 2014 Sep 10.
To compare the effect on the corneal endothelium of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery.
Private clinic, Tasmania, Australia.
Prospective comparative cohort study.
Femtosecond laser-assisted cataract surgery (study group) or conventional phacoemulsification (control group) was performed. The central corneal thickness, central 3.0 mm corneal volume, volume stress index, and central endothelial cell density (ECD) were measured preoperatively and 1 day, 3 weeks, and 6 months postoperatively.
The study group comprised 405 eyes and the control group, 215 eyes. Postoperative corneal edema was significantly less in the study group at 1 day and 3 weeks. However, the difference was negligible at 6 months. The study group had significant reductions in ECD loss compared with the control group [corrected] at 3 weeks but not at 6 months (6-month mean -150 cells/mm(2) ± 244 [SD] versus -149 cells/mm(2) ± 233). Eyes in the study group with laser-automated corneal incisions had greater endothelial cell loss at 6 months than eyes in the study group with manual corneal incisions and eyes in the control group (P<.0001). Eyes in the study group with zero effective phaco time and manually created corneal incisions had statistically significantly less endothelial cell loss at 6 months than the other groups (P<.0001).
Femtosecond laser pretreatment for cataract surgery was associated with a significant reduction in early postoperative corneal edema and endothelial cell loss compared with conventional phacoemulsification; however, the difference diminished with time. Laser-automated corneal incisions seemed to adversely affect the corneal endothelial cells.
No author has a financial or proprietary interest in any material or method mentioned.
比较飞秒激光辅助白内障手术与传统超声乳化白内障手术对角膜内皮的影响。
澳大利亚塔斯马尼亚的私人诊所。
前瞻性比较队列研究。
进行飞秒激光辅助白内障手术（研究组）或传统超声乳化手术（对照组）。术前及术后1天、3周和6个月测量中央角膜厚度、中央3.0毫米角膜体积、体积应力指数和中央内皮细胞密度（ECD）。
研究组有405只眼，对照组有215只眼。研究组术后1天和3周的角膜水肿明显较少。然而，6个月时差异可忽略不计。与对照组相比，研究组在3周时ECD损失显著减少，但6个月时未减少（6个月时平均 -150个细胞/平方毫米±244 [标准差] 对比 -149个细胞/平方毫米±233）。研究组中采用激光自动角膜切口的眼睛在6个月时的内皮细胞损失比采用手动角膜切口的研究组眼睛和对照组眼睛更大（P<0.0001）。研究组中有效超声乳化时间为零且采用手动制作角膜切口的眼睛在6个月时的内皮细胞损失在统计学上显著少于其他组（P<0.0001）。
与传统超声乳化相比，白内障手术的飞秒激光预处理与术后早期角膜水肿和内皮细胞损失的显著减少相关；然而，差异随时间减小。激光自动角膜切口似乎对角膜内皮细胞有不利影响。
没有作者对文中提及的任何材料或方法有财务或专利权益。
