Ang Robert Edward Ty, Quinto Michelle Marie Salcedo, Cruz Emerson Marquez, Rivera Mark Christian Reyes, Martinez Gladness Henna Austria
1Asian Eye Institute, Rockwell Center, Makati City, 1200 Philippines.
Cardinal Santos Medical Center, 10 Wilson St., San Juan City, 1502 Philippines.
Eye Vis (Lond). 2018 Apr 23;5:8. doi: 10.1186/s40662-018-0102-5. eCollection 2018.
To compare femtosecond laser-assisted versus conventional phacoemulsification in terms of visual and refractive outcomes, cumulative dissipated energy, anterior chamber inflammation and endothelial cell loss.
In this retrospective cohort study, records of eyes that underwent femtosecond laser-assisted cataract surgery (FLACS) or conventional phacoemulsification (CP) were reviewed. The Victus femtosecond laser (Bausch and Lomb, Germany) was used to carry out corneal incisions, anterior capsulotomy, and lens fragmentation in FLACS procedures. Manifest refraction spherical equivalence (MRSE), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), cumulative dissipated energy (CDE), postoperative cells and flare and endothelial cell count data were collected. Subgroup analysis of the visual acuity tests was performed based on the type of intraocular lens implanted (monofocal, monofocal toric, multifocal, multifocal toric, accommodating).
A total of 735 eyes were included in the study (296 eyes for the FLACS group and 439 eyes for the CP group). At one year follow-up, 120 eyes comprised the FLACS group and 265 eyes for the CP group. MRSE in the FLACS group was - 0.16 ± 0.58 D and - 0.20 ± 0.52 D in the CP group ( = 0.50). UDVA in the FLACS group was 20/25 (mean logMAR 0.12 ± 0.13) and 20/25 (mean logMAR 0.11 ± 0.13) in the CP group ( = 0.48). CDVA was 20/20 (mean logMAR 0.03 ± 0.07) in the FLACS group and 20/20 (mean logMAR 0.02 ± 0.06) in the CP group ( = 0.15). No statistically significant trend was seen for FLACS versus CP by intraocular type for visual acuity. CDE for the different cataract grades ranged from 6.97 ± 5.74 to 29.02 ± 16.07 in the FLACS group and 7.59 ± 6.42 to 35.69 ± 18.30 in the CP group. The FLACS group was significantly lower for post-operative central corneal edema ( = 0.05), cells and flare ( = 0.01), and endothelial cell loss ( = 0.04).
Femtosecond laser-assisted cataract surgery and conventional phacoemulsification had similar refractive and visual outcomes. Phacoemulsification energy, anterior chamber inflammation and corneal endothelial cell loss were less in the femtosecond laser group.
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在视觉和屈光效果、累积消散能量、前房炎症及内皮细胞损失方面的差异。
在这项回顾性队列研究中，对接受飞秒激光辅助白内障手术（FLACS）或传统超声乳化白内障手术（CP）的患者眼部记录进行回顾。在FLACS手术中，使用Victus飞秒激光（德国博士伦公司）进行角膜切口、前囊切开及晶状体破碎。收集显验光球镜等效度（MRSE）、未矫正远视力（UDVA）、矫正远视力（CDVA）、累积消散能量（CDE）、术后细胞及闪光和内皮细胞计数数据。基于植入人工晶状体的类型（单焦点、单焦点散光、多焦点、多焦点散光、可调节）对视力测试进行亚组分析。
该研究共纳入735只眼（FLACS组296只眼，CP组439只眼）。在一年随访时，FLACS组有120只眼，CP组有265只眼。FLACS组的MRSE为-0.16±0.58 D，CP组为-0.20±0.52 D（P = 0.50）。FLACS组的UDVA为20/25（平均logMAR 0.12±0.13），CP组为20/25（平均logMAR 0.11±0.13）（P = 0.48）。FLACS组的CDVA为20/20（平均logMAR 0.03±0.07），CP组为20/20（平均logMAR 0.02±0.06）（P = 0.15）。按人工晶状体类型分析，FLACS组与CP组在视力方面无统计学显著差异。不同白内障分级的FLACS组CDE范围为6.97±5.74至29.02±16.07，CP组为7.59±6.42至35.69±18.30。FLACS组术后中央角膜水肿（P = 0.05）、细胞及闪光（P = 0.01）和内皮细胞损失（P = 0.04）明显更低。
飞秒激光辅助白内障手术与传统超声乳化白内障手术在屈光和视觉效果方面相似。飞秒激光组的超声乳化能量、前房炎症及角膜内皮细胞损失更少。
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