Kang Min-Ji, Lee Yong-Eun, Choi Jun-Sub, Joo Choun-Ki
Department of Ophthalmology and Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Seoul St. Mary's Hospital, Seoul, Republic of Korea.
PLoS One. 2018 Jan 5;13(1):e0190858. doi: 10.1371/journal.pone.0190858. eCollection 2018.
In femtosecond laser-assisted cataract surgery, the parameter such as horizontal spot spacing and energy level can be adjusted. Although there have been several studies reported on various laser systems, showing the effects of varying energy levels and horizontal spot spacing on lens capsulotomy cut edges, none have been reported on the Catalys laser system (Abbott Medical Optics, Inc., Santa Ana, CA). The aim of this study is to evaluate, using scanning electron microscopy (SEM), the quality of the cut edges of the laser lens capsulotomy obtained using the Catalys Laser System, using different horizontal spot spacing and energy levels, and to determine the ideal parameters based on SEM results. Fifty rabbit capsulorhexis specimens from a femtosecond laser with different spot spacing and energy settings were divided into five groups randomly. Spot spacing was 3 um and laser pulse energy was 4 uJ in group 1. The respective values were 5 um and 2 uJ in group 2, 5 um and 4 uJ in group 3, 5 um and 6 uJ in group 4, and 7 um and 4 uJ in group 5. All samples were evaluated using SEM to compare the number of tags per capsulotomy and the laser emission time. Group 1 had a significantly lower tag formation than groups 3 and 5 (P = 0.042 and 0.021, respectively). Although the laser emission time increased about 1.5 sec as the spot spacing increased from 3 to 7 um, the quality of the cut was smoother in group 1 because of overlapping effect of photodisruption cavities. There was no significant difference between groups 2, 3 and 4 at different laser energy settings. In an ex-vivo study, samples from an energy setting of 10 uJ showed increased irregularity and damage. The degree of irregularity was higher at increasing spot spacing and laser energy settings, with abundant tag formation. Dense spot spacing with low-energy settings provide a better cut quality, which is probably correlated with the reduction in anterior capsular tear complications.
在飞秒激光辅助白内障手术中，诸如水平光斑间距和能级等参数可以进行调整。尽管已有多项关于各种激光系统的研究报告，展示了不同能级和水平光斑间距对晶状体囊切开术切口边缘的影响，但尚未有关于Catalys激光系统（雅培医疗光学公司，加利福尼亚州圣安娜）的相关报告。本研究的目的是使用扫描电子显微镜（SEM）评估使用Catalys激光系统、不同水平光斑间距和能级获得的激光晶状体囊切开术切口边缘的质量，并根据SEM结果确定理想参数。将来自飞秒激光的50个具有不同光斑间距和能量设置的兔撕囊标本随机分为五组。第1组的光斑间距为3微米，激光脉冲能量为4微焦。第2组的相应值为5微米和2微焦，第3组为5微米和4微焦，第4组为5微米和6微焦，第5组为7微米和4微焦。使用SEM对所有样本进行评估，以比较每个囊切开术的标签数量和激光发射时间。第1组的标签形成明显低于第3组和第5组（分别为P = 0.042和0.021）。尽管随着光斑间距从3微米增加到7微米，激光发射时间增加了约1.5秒，但由于光破裂腔的重叠效应，第1组的切口质量更光滑。在不同激光能量设置下，第2组、第3组和第4组之间没有显著差异。在一项体外研究中，能量设置为10微焦的样本显示出不规则性和损伤增加。随着光斑间距和激光能量设置的增加，不规则程度更高，标签形成丰富。低能量设置下的密集光斑间距可提供更好(的)切口质量，这可能与前囊膜撕裂并发症的减少相关。
