Abell Robin G, Darian-Smith Erica, Kan Jeffrey B, Allen Penelope L, Ewe Shaun Y P, Vote Brendan J
From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
J Cataract Refract Surg. 2015 Jan;41(1):47-52. doi: 10.1016/j.jcrs.2014.06.025. Epub 2014 Nov 11.
To compare the intraoperative complications and safety of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery.
Single center.
Prospective consecutive comparative cohort case series.
Eyes had femtosecond laser-assisted cataract surgery (study group) or phacoemulsification (control group) by 1 of 5 surgeons. The technique comprised manual corneal incisions and capsulorhexis or laser-assisted anterior capsulotomy, lens fragmentation, corneal incisions, phacoemulsification, and intraocular lens implantation.
The study group comprised 1852 eyes and the control group, 2228 eyes. Patient demographics were similar between groups. There was a significant improvement in vacuum/docking attempts, surface recognition adjustments, treatment, and vacuum time during the laser procedure in the study group. Anterior capsule tears occurred in 1.84% of eyes in the study group and 0.22% of eyes in the control group (P < .0001). There was no difference in the incidence of anterior capsule tears between the first half and second half of laser-assisted cases. Anterior capsulotomy tags occurred in 1.62% study group eyes. There was no significant difference in posterior capsule tears between the 2 groups (0.43% versus 0.18%). The incidence of significant intraoperative corneal haze and miosis was higher and the effective phacoemulsification time significantly lower in the study group (P < .001).
Significant intraoperative complications likely to affect refractive outcomes and patient satisfaction were low overall. The 2 cataract surgery techniques appear to be equally safe. Although anterior capsule tears remain a concern, the safety of femtosecond-assisted cataract surgery in terms of posterior capsule complications was equal to that of phacoemulsification.
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的术中并发症及安全性。
单中心。
前瞻性连续比较队列病例系列。
由5位外科医生之一对眼睛进行飞秒激光辅助白内障手术（研究组）或超声乳化手术（对照组）。技术包括手动角膜切口和撕囊或激光辅助前囊切开、晶状体破碎、角膜切口、超声乳化及人工晶状体植入。
研究组有1852只眼，对照组有2228只眼。两组患者人口统计学特征相似。研究组在激光手术过程中的真空/对接尝试、表面识别调整、治疗及真空时间方面有显著改善。研究组1.84%的眼睛发生前囊撕裂，对照组为0.22%（P <.0001）。飞秒激光辅助手术病例的前半年和后半年之间前囊撕裂发生率无差异。研究组1.62%的眼睛出现前囊切开标签。两组后囊撕裂发生率无显著差异（0.43%对0.18%）。研究组术中显著角膜混浊和瞳孔缩小发生率更高，有效超声乳化时间显著更短（P <.001）。
总体而言，可能影响屈光结果和患者满意度的显著术中并发症较低。两种白内障手术技术似乎同样安全。尽管前囊撕裂仍是一个问题，但飞秒激光辅助白内障手术在术后囊并发症方面的安全性与超声乳化手术相当。
没有作者对文中提及的任何材料或方法有财务或专有利益。
