Serrao Sebastiano, Giannini Daniela, Schiano-Lomoriello Domenico, Lombardo Giuseppe, Lombardo Marco
From the Fondazione G.B. Bietti IRCCS (Serrao, Giannini, Schiano-Lomoriello, M. Lombardo), Vision Engineering Italy srl (G. Lombardo), Rome, and Consiglio Nazionale delle Ricerche (G. Lombardo), Istituto per i Processi Chimico-Fisici, Messina, Italy.
From the Fondazione G.B. Bietti IRCCS (Serrao, Giannini, Schiano-Lomoriello, M. Lombardo), Vision Engineering Italy srl (G. Lombardo), Rome, and Consiglio Nazionale delle Ricerche (G. Lombardo), Istituto per i Processi Chimico-Fisici, Messina, Italy.
J Cataract Refract Surg. 2017 Jan;43(1):80-86. doi: 10.1016/j.jcrs.2016.08.038.
To evaluate the changes in corneal topography and corneal higher-order wavefront aberrations with the use of a new technique in which clear corneal incisions (CCIs) for cataract surgery are created with a femtosecond laser.
IRCCS Fondazione G.B. Bietti, Rome, Italy.
Prospective randomized case series.
Cataract surgery patients were randomized into 2 groups. In the study group, a 3-plane CCI was created with a femtosecond laser. In the control group, the single plane-angled CCI was created manually using disposable knives. Simulated keratometry (K) values and corneal higher-order wavefront aberrations with 3.5 mm and 6.0 mm pupils were compared between groups.
Each group comprised 10 eyes. At 6 months, the mean change in K values from preoperatively was 0.16 diopter (D) ± 0.14 (SD) in the study group and 0.34 ± 0.16 D in the control group, with no differences between groups (P > .05). The manual CCI significantly increased corneal higher-order wavefront aberrations with 3.5 mm and 6.0 mm pupils (both P < .05). In the study group, corneal higher-order wavefront aberrations increased significantly with a 6.0 mm pupil only (P ≤ .02). The induced changes in corneal higher-order wavefront aberrations were significantly different between groups over both pupil sizes (P < .05).
The femtosecond laser-created CCI did not induce significant changes in simulated K or corneal higher-order wavefront aberrations over the mesopic pupil size. The lower amount of induced corneal higher-order wavefront aberrations with the new technique than with manual CCI could be related to the different geometry of the 2 techniques.
运用一种新技术评估白内障手术中使用飞秒激光制作透明角膜切口（CCI）时角膜地形图和角膜高阶波前像差的变化。
意大利罗马IRCCS Fondazione G.B. Bietti。
前瞻性随机病例系列。
白内障手术患者被随机分为两组。研究组使用飞秒激光制作三平面CCI。对照组使用一次性刀具手动制作单平面斜角CCI。比较两组之间模拟角膜曲率（K）值以及3.5毫米和6.0毫米瞳孔下的角膜高阶波前像差。
每组包括10只眼。6个月时，研究组K值较术前的平均变化为0.16屈光度（D）±0.14（标准差），对照组为0.34±0.16 D，两组之间无差异（P>.05）。手动制作的CCI使3.5毫米和6.0毫米瞳孔下的角膜高阶波前像差显著增加（均P<.05）。在研究组中，仅6.0毫米瞳孔时角膜高阶波前像差显著增加（P≤.02）。在两种瞳孔大小下，两组之间角膜高阶波前像差的诱导变化均有显著差异（P<.05）。
飞秒激光制作的CCI在中瞳孔大小下未引起模拟K值或角膜高阶波前像差的显著变化。与手动制作CCI相比，新技术诱导的角膜高阶波前像差量较低可能与两种技术的不同几何形状有关。
