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飞秒激光辅助白内障手术与标准超声乳化白内障手术对比:来自欧洲白内障与屈光手术质量结果登记处的研究

Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: Study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery.

作者信息

Manning Sonia, Barry Peter, Henry Ype, Rosen Paul, Stenevi Ulf, Young David, Lundström Mats

机构信息

From the Department of Ophthalmology (Manning), University Hospital Waterford, Waterford, Ireland, the Department of Ophthalmology (Henry), Vumc, Amsterdam, the Netherlands, Oxford Eye Hospital (Rosen), Oxford, and the Department of Mathematics and Statistics (Young), University of Strathclyde, Glasgow, United Kingdom, and the Department of Ophthalmology (Stenevi), Sahlgren's University Hospital, Molndal, and the Department of Clinical Sciences (Lundström), Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.

From the Department of Ophthalmology (Manning), University Hospital Waterford, Waterford, Ireland, the Department of Ophthalmology (Henry), Vumc, Amsterdam, the Netherlands, Oxford Eye Hospital (Rosen), Oxford, and the Department of Mathematics and Statistics (Young), University of Strathclyde, Glasgow, United Kingdom, and the Department of Ophthalmology (Stenevi), Sahlgren's University Hospital, Molndal, and the Department of Clinical Sciences (Lundström), Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.

出版信息

J Cataract Refract Surg. 2016 Dec;42(12):1779-1790. doi: 10.1016/j.jcrs.2016.10.013.

Abstract

PURPOSE

To compare the visual, refractive, and adverse outcomes of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery.

SETTING

Cataract surgery clinics in 9 European countries and Australia (femtosecond-assisted) and 18 European countries and Australia (conventional).

DESIGN

Multicenter case-control study.

METHODS

Eyes having femtosecond laser-assisted cataract surgery were matched to eyes from the European Registry of Quality Outcomes for Cataract and Refractive Surgery phacoemulsification cataract surgery database for preoperative corrected distance visual acuity (CDVA), age, and preoperative risk factors. Intraoperative and postoperative complications, postoperative CDVA, and refractive outcome were compared. The follow-up was 7 to 60 days.

RESULTS

The study matched 2814 femtosecond-assisted cases to 4987 conventional phacoemulsification cases. Femtosecond-assisted surgery compared as follows to conventional phacoemulsification: posterior capsule complications, 0.7% versus 0.4%; postoperative logMAR CDVA, 0.05 (6/6) versus 0.03 (6/6); worse postoperative CDVA at follow-up (by 5 letters or more), 1.0% versus 0.4%; CDVA 0.3 (6/12) or better, 96.3% versus 97.1%; absolute biometry prediction error, 0.43 diopter (D) versus 0.40 D; within ±0.5 D of target, 72% versus 74.3%; and postoperative complications, 3.4% versus 2.3%.

CONCLUSIONS

Femtosecond laser-assisted cataract surgery did not yield better visual or refractive outcomes than conventional phacoemulsification cataract surgery. Intraoperative complications were similar and low in both groups. Postoperative complications were lower in conventional phacoemulsification cataract surgery.

FINANCIAL DISCLOSURE

None of the authors has a financial or proprietary interest in any material or method mentioned.

摘要

目的

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视觉、屈光及不良结局。

设置

9个欧洲国家和澳大利亚的白内障手术诊所(飞秒激光辅助)以及18个欧洲国家和澳大利亚的白内障手术诊所(传统手术)。

设计

多中心病例对照研究。

方法

将接受飞秒激光辅助白内障手术的眼睛与欧洲白内障和屈光手术质量结果登记处超声乳化白内障手术数据库中的眼睛进行匹配,匹配因素为术前矫正远视力(CDVA)、年龄和术前危险因素。比较术中及术后并发症、术后CDVA和屈光结局。随访时间为7至60天。

结果

该研究将2814例飞秒激光辅助手术病例与4987例传统超声乳化手术病例进行了匹配。飞秒激光辅助手术与传统超声乳化手术相比结果如下:后囊并发症,0.7%对0.4%;术后logMAR CDVA,0.05(6/6)对0.03(6/6);随访时术后CDVA更差(相差5行或更多),1.0%对0.4%;CDVA为0.3(6/12)或更好,96.3%对97.1%;绝对生物测量预测误差,0.43屈光度(D)对0.40 D;在目标值±0.5 D范围内,72%对74.3%;以及术后并发症,3.4%对2.3%。

结论

飞秒激光辅助白内障手术在视觉或屈光结局方面并不优于传统超声乳化白内障手术。两组术中并发症相似且发生率较低。传统超声乳化白内障手术的术后并发症更低。

财务披露

作者均未对文中提及的任何材料或方法拥有财务或专利权益。

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