[300例飞秒激光辅助白内障手术的初步评估]

[Preliminary evaluation of the femtosecond laser-assisted cataract surgery in 300 cases].

作者信息

Wang Yong, Bao Xianyi, Zhou Yanli, Xu Rong, Peng Tingting, Sun Ming, Cao Danmin, He Ling

机构信息

Wuhan Aier Eye Hospital, Aier School of Ophthalmology, Central South University, Wuhan 430063, China; Email:

Wuhan Aier Eye Hospital, Aier School of Ophthalmology, Central South University, Wuhan 430063, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2015 Sep;51(9):689-93.

PMID:26693655

Abstract

OBJECTIVE

To evaluate the clinical outcome of the femtosecond laser-assisted cataract surgery (FLACS) in our first 300 cases.

METHODS

In this retrospective study, the study group comprised 300 cases (300 eyes) in which FLACS was done. The control group comprised 300 cases (300 eyes) in which phacoemulsification was performed. The steps of the FLACS included capsulotomy, lens fragmentation, corneal incisions, and creation of incisions within the peripheral cornea to aid the correction of pre-existing astigmatism. After the FLACS, 2.2-mm coaxial micro-incision phacoemulsification and implantation of an intraocular lens were operated. The preoperative best corrected visual acuity (BCVA) and postoperative uncorrected visual acuity (UCVA), the cumulative dissipated energy (CDE) of the phacoemulsification, and the parameters of the FLACS, including the docking time, the suction time and the laser time, were recorded. The complications of the FLACS were analyzed.

RESULTS

The FLACS was successfully completed in 99.33% of the cases. The docking time was (24.6 ± 16.8) sec, the suction time was (101.27 ± 20.09) sec, and the laser time was (23.3 ± 5.5) sec. The most common complications of the FLACS included suction break (7/300, 2.33%), subconjunctival hemorrhage (58/300, 19.33%), pupillary constriction (47/300, 15.67%), incision at a wrong site (13/300, 4.33%), anterior capsular tag (17/300, 5.67%), decentration of the capsulorhexis (11/300, 3.67%), failure to split the lens nucleus (5/300, 1.67%), and posterior capsular ruptures (1/300, 0.33%). The CDE was 5.52 ± 5.18 in the FLACS group and 8.37 ± 7.91 in the traditional phaco group (P < 0.05). The UCVA was 0.12 ± 0.08 and 0.13 ± 0.11 at 1 month after the FLACS and traditional phaco, respectively (P > 0.05).

CONCLUSIONS

Compared with the conventional phacoemulsification surgery, the FLACS can achieve less CDE and better early postoperative visual acuity. Long-term effects remain to be investigated.

摘要

目的

评估我院首批300例飞秒激光辅助白内障手术（FLACS）的临床效果。

方法

在这项回顾性研究中，研究组包括300例（300眼）接受FLACS手术的患者。对照组包括300例（300眼）接受超声乳化白内障吸除术的患者。FLACS的步骤包括晶状体囊切开术、晶状体破碎、角膜切口以及在周边角膜内制作切口以辅助矫正术前存在的散光。FLACS术后，进行2.2毫米同轴微切口超声乳化白内障吸除术并植入人工晶状体。记录术前最佳矫正视力（BCVA）和术后未矫正视力（UCVA）、超声乳化白内障吸除术的累积消散能量（CDE）以及FLACS的参数，包括对接时间、抽吸时间和激光时间。分析FLACS的并发症。

结果

99.33%的病例成功完成FLACS手术。对接时间为（24.6±16.8）秒，抽吸时间为（101.27±20.09）秒，激光时间为（23.3±5.5）秒。FLACS最常见的并发症包括抽吸中断（7/300，2.33%）、结膜下出血（58/300，19.33%）、瞳孔收缩（47/300，15.67%）、切口位置错误（13/300，4.33%）、前囊膜标签（17/300，5.67%）、撕囊偏中心（11/300，3.67%）、未能劈开晶状体核（5/300，1.67%）和后囊膜破裂（1/300，0.33%）。FLACS组的CDE为5.52±5.18，传统超声乳化组为8.37±7.91（P<0.05）。FLACS和传统超声乳化术后1个月时的UCVA分别为0.12±0.08和0.13±0.11（P>0.05）。