Diakonis Vasilios F, Yesilirmak Nilufer, Sayed-Ahmed Ibrahim O, Warren Daniel P, Kounis George A, Davis Zachary, Cabot Florence, Yoo Sonia H, O'Brien Terrence P, Donaldson Kendall E
J Refract Surg. 2016 Feb;32(2):84-8. doi: 10.3928/1081597X-20151229-03.
To assess pupil diameter before and after femtosecond laser-assisted cataract surgery (FLACS) pretreatment and compare the outcomes of three laser platforms.
This prospective observational case series included consecutive patients scheduled to undergo cataract extraction using FLACS between August 2013 and February 2015. All eyes received FLACS pretreatment using three laser platforms: LenSx (Alcon Laboratories, Inc., Fort Worth, TX), Catalys (Abbott Medical Optics Inc., Santa Ana, CA), and Victus (Bausch & Lomb, Inc., Rochester, NY). The same protocol for preoperative medical mydriasis was used for all patients, and pupil diameter was assessed immediately before and 3 minutes after FLACS using a surgical ruler.
A total of 198 eyes of 161 patients were included in the study. Mean pupillary miosis was 1.42 ± 1.26 mm for the LenSx, 0.66 ± 0.89 mm for the Catalys, and 0.14 ± 0.34 mm for the Victus groups. Furthermore, 8 of the 198 eyes (4.0%) demonstrated a pupil diameter of less than 5 mm after FLACS and 48 eyes (24.24%) demonstrated a pupil diameter of 6 mm or less. There was a statistically significant decrease in pupil diameter for all groups individually (P < .05). There was also a statistically significant difference among the three groups (P < .05), with LenSx inducing the highest degree of miosis, followed by Catalys, and finally Victus. A correlation between the pupil diameter before FLACS and degree of FLACS-induced miosis was demonstrated (P < .05), with larger pupil diameter before FLACS associated with greater miosis.
FLACS pretreatment seems to induce significant pupillary miosis with all laser platforms assessed in this study. The decrease in pupil diameter after FLACS reached clinical significance for cataract extraction (< 5 mm) in 4.0% of cases, whereas 20.2% of eyes demonstrated small pupil diameter (≤ 6 mm) after FLACS pretreatment.
评估飞秒激光辅助白内障手术（FLACS）预处理前后的瞳孔直径，并比较三种激光平台的效果。
本前瞻性观察性病例系列纳入了2013年8月至2015年2月期间计划使用FLACS进行白内障摘除术的连续患者。所有眼睛均使用三种激光平台进行FLACS预处理：LenSx（爱尔康实验室公司，沃思堡，德克萨斯州）、Catalys（雅培医疗光学公司，圣安娜，加利福尼亚州）和Victus（博士伦公司，罗切斯特，纽约州）。所有患者均采用相同的术前药物散瞳方案，并使用手术尺在FLACS术前即刻和术后3分钟评估瞳孔直径。
本研究共纳入161例患者的198只眼。LenSx组平均瞳孔缩小为1.42±1.26mm，Catalys组为0.66±0.89mm，Victus组为0.14±0.34mm。此外，198只眼中有8只（4.0%）在FLACS术后瞳孔直径小于5mm，48只眼（24.24%）瞳孔直径小于或等于6mm。各单独组的瞳孔直径均有统计学显著下降（P<.05）。三组之间也存在统计学显著差异（P<.05），LenSx引起的瞳孔缩小程度最高，其次是Catalys，最后是Victus。FLACS术前瞳孔直径与FLACS诱导的瞳孔缩小程度之间存在相关性（P<.05），FLACS术前瞳孔直径越大，瞳孔缩小越明显。
在本研究评估的所有激光平台中，FLACS预处理似乎都会引起显著的瞳孔缩小。FLACS术后瞳孔直径的减小在4.0%的白内障摘除病例中达到临床意义（<5mm），而20.2%的眼睛在FLACS预处理后表现为小瞳孔直径（≤6mm）。
