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飞秒激光辅助与手动透明角膜切口的评估及其对手术性散光和高阶像差的影响。

Evaluation of femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism and higher-order aberrations.

作者信息

Nagy Zoltán Z, Dunai Arpád, Kránitz Kinga, Takács Agnes Ildikó, Sándor Gábor László, Hécz Réka, Knorz Michael C

出版信息

J Refract Surg. 2014 Aug;30(8):522-5. doi: 10.3928/1081597X-20140711-04.

Abstract

PURPOSE

To evaluate femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism (SIA) and corneal higher-order aberrations (HOAs).

METHODS

In a prospective randomized study, conventional phacoemulsification with a 2.8-mm clear corneal incision using a disposable keratome was performed in 20 eyes of 20 patients (manual group), and femtosecond laser-assisted cataract surgery with a 2.8-mm biplanar clear corneal tunnel created by a femtosecond laser (LenSx; Alcon Laboratories, Inc., Aliso Viejo, CA) was performed in 20 eyes of 20 patients (femtosecond laser group). Corneal topography readings and corneal wavefront aberrations (diameter: 9.0 mm) were obtained using a Scheimpflug camera (Pentacam HR; Oculus Optikgerate, Wetzlar, Germany) preoperatively and 3 months postoperatively.

RESULTS

There was no significant difference in SIA between the groups (femtosecond laser group: 0.47 ± 0.13 vs manual group: 0.41 ± 0.14; P = .218), but the axis deviation of the SIA axis from the previously planned axis was significantly smaller in the femtosecond laser group compared to the manual group (4.47°± 2.59° vs 7.38°± 4.72°, respectively; P = .048). Corneal HOAs increased significantly in both groups (femtosecond laser group: 0.13 ± 0.09 to 0.18 ± 0.12, P = .025; manual group: 0.13 ± 0.05 to 0.15 ± 0.05, P = .002), but preoperative and postoperative values did not differ significantly between them (P = .472 and .078, respectively). Lower-order and total corneal aberration values remained stable in both groups (P > .05).

CONCLUSIONS

There was no difference in SIA and induced HOAs between manual and femtosecond laser-created clear corneal incisions.

摘要

目的

评估飞秒激光辅助和手动制作的透明角膜切口及其对手术性散光(SIA)和角膜高阶像差(HOAs)的影响。

方法

在一项前瞻性随机研究中,20例患者的20只眼采用一次性角膜刀制作2.8mm透明角膜切口进行传统白内障超声乳化手术(手动组),另外20例患者的20只眼采用飞秒激光(LenSx;爱尔康实验室公司,美国加利福尼亚州阿利索维耶霍)制作2.8mm双平面透明角膜隧道进行飞秒激光辅助白内障手术(飞秒激光组)。术前及术后3个月使用眼前节分析仪(Pentacam HR;德国韦茨拉尔奥culus Optikgerate公司)获取角膜地形图读数及角膜波前像差(直径:9.0mm)。

结果

两组间SIA无显著差异(飞秒激光组:0.47±0.13,手动组:0.41±0.14;P = 0.218),但飞秒激光组SIA轴与先前计划轴的轴偏角显著小于手动组(分别为4.47°±2.59°和7.38°±4.72°;P = 0.048)。两组角膜HOAs均显著增加(飞秒激光组:从0.13±0.09增至0.18±0.12,P = 0.025;手动组:从0.13±0.05增至0.15±0.05,P = 0.002),但两组术前及术后值差异无统计学意义(分别为P = 0.472和0.078)。两组低阶及总角膜像差值均保持稳定(P>0.05)。

结论

手动制作与飞秒激光制作的透明角膜切口在SIA及诱导性HOAs方面无差异。

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