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[飞秒激光辅助白内障手术与传统超声乳化白内障手术治疗晶状体半脱位患者]

[Femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery in patients with lens subluxation].

作者信息

Pachtaev N P, Kulikov I V, Pikusova S N

机构信息

Cheboksary branch of S. Fyodorov Eye Microsurgery Federal State Institution, 10 Traktorostroiteley pr., Cheboksary, Chuvash Republic, Russian Federation, 428000; Postgraduate Doctors' Training Institute, Ministry of Health of the Chuvash Republic, 3 Krasnaya Sq., Cheboksary, Chuvash Republic, Russian Federation, 428032; Chuvash State University named after I.N. Ulyanov, 15 Moskovskiy pr., Cheboksary, Chuvash Republic, Russian Federation, 428010.

Cheboksary branch of S. Fyodorov Eye Microsurgery Federal State Institution, 10 Traktorostroiteley pr., Cheboksary, Chuvash Republic, Russian Federation, 428000.

出版信息

Vestn Oftalmol. 2018;134(3):65-72. doi: 10.17116/oftalma2018134365.

Abstract

PURPOSE

To analyze the results of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS) in patients with 1-2 degree lens subluxation.

MATERIAL AND METHODS

The follow-up involved 86 patients (89 eyes). The 1 group comprised 34 patients (35 eyes) that underwent FLACS; the 2 group included 52 patients (54 eyes) who underwent CPCS.

RESULTS

At day four of the follow-up central corneal thickness was significantly lower after FLACS (p=0.024), but the difference did not remain statistically reliable by 1.5 months after the surgery. At discharge day and 4 months after the surgery uncorrected visual acuity (UCVA) after FLACS reliably exceeded UCVA of the 2 group patients (p=0.00) with mean UCVA being 0.61±0.29 and 0.42±0.25 respectively. Internal higher order aberrations (HOA) in 5.0 mm zone in the 1 group decreased by 4 times and amounted to 0.236±0.06 μm, in the 2 group increased by 4.1 times and was 4.606±8.16 μm; the difference between the groups was statistically significant (p<0.001). Mean endothelial cells density after FLACS was 2551.91±321.55 cells/mm, after CPCS - 2352.35±436.68 cells/mm (p<0.005). Complications after FLACS included 2 cases (5.71%) of posterior capsular rupture and 1 case (2.8%) of post-op corneal edema; patients after CPCS had 6 (11.1%) and 12 (22.2%) complication cases respectively.

CONCLUSION

FLACS is the safer and more effective surgery choice for patients with 1-2 degree lens subluxation in comparison with CPCS; it decreases the risk of possible complications and provides faster postoperative rehabilitation.

摘要

目的

分析飞秒激光辅助白内障手术(FLACS)和传统超声乳化白内障手术(CPCS)在1-2度晶状体半脱位患者中的手术效果。

材料与方法

随访86例患者(89只眼)。第1组包括34例(35只眼)接受FLACS手术的患者;第2组包括52例(54只眼)接受CPCS手术的患者。

结果

随访第4天时,FLACS术后中央角膜厚度显著降低(p=0.024),但术后1.5个月时该差异不再具有统计学意义。出院时及术后4个月,FLACS术后的未矫正视力(UCVA)可靠地超过第2组患者的UCVA(p=0.00),平均UCVA分别为0.61±0.29和0.42±0.25。第1组5.0 mm区域内的内部高阶像差(HOA)降低了4倍,为0.236±0.06μm,第2组增加了4.1倍,为4.606±8.16μm;两组间差异具有统计学意义(p<0.001)。FLACS术后平均内皮细胞密度为2551.91±321.55个/mm,CPCS术后为2352.35±436.68个/mm(p<0.005)。FLACS术后并发症包括2例(5.71%)后囊破裂和1例(2.8%)术后角膜水肿;CPCS术后患者分别有6例(11.1%)和12例(22.2%)并发症。

结论

与CPCS相比,FLACS是1-2度晶状体半脱位患者更安全、更有效的手术选择;它降低了可能并发症的风险,并提供了更快的术后康复。

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