飞秒激光辅助白内障手术（FLACS）与传统超声乳化白内障吸除术中累积离散能量（CDE）的比较。
Comparison of cumulative dispersed energy (CDE) in femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification.
作者信息
Saeedi Osamah J, Chang Luke Y, Ong Sharon R, Karim Syed A, Abraham Danielle S, Rosenthal Geoffrey L, Hammer Andrew, Spagnolo Brad V, Betancourt Arturo E
机构信息
Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 W. Redwood Street, Suite 470, Baltimore, MD, 21201, USA.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA.
出版信息
Int Ophthalmol. 2019 Aug;39(8):1761-1766. doi: 10.1007/s10792-018-0996-x. Epub 2018 Jul 27.
PURPOSE
To compare the amount of phacoemulsification ultrasound energy used between eyes undergoing femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification.
METHODS
One eye of consecutive patients undergoing routine non-complicated phacoemulsification from January 2014 to December of 2015 was included in the analysis. FLACS was performed using the Alcon LenSx. Linear regression was used for analysis with type of surgery (FLACS versus conventional phacoemulsification) as the exposure and cumulative dispersed energy (CDE) as the outcome variable. Age, surgeon, eye side, and eye sequence (first versus second eye) were covariates.
RESULTS
A total of 1159 surgeries met inclusion criteria. The average age of the cohort was 70.6 (SD 8.6) years, 590 cases (51%) were performed by surgeon 1, and 582 cases (50%) were right eyes. Overall, FLACS resulted in significantly lower CDE as compared to conventional phacoemulsification (β = 0.89, 95% CI 0.83, 0.95). When stratified by eye side and surgeon, FLACS performed on left eyes operated on by surgeon 1 resulted in lower CDE as compared to conventional phacoemulsification (β = 0.76, 95% CI 0.66, 0.87), but not for right eyes operated on by surgeon 1 (β = 0.92, 95% CI 0.79, 1.07) or for eyes operated on by surgeons 2 or 3.
CONCLUSIONS
The use of FLACS on the Alcon LenSx platform results in a small decrease in phacoemulsification energy as compared to conventional phacoemulsification in certain cases. Further study assessing optimal laser settings and surgical technique is necessary.
目的
比较飞秒激光辅助白内障手术（FLACS）与传统超声乳化白内障吸除术之间超声乳化所用的能量。
方法
纳入2014年1月至2015年12月期间接受常规非复杂性超声乳化白内障吸除术的连续患者的一只眼睛进行分析。使用爱尔康LenSx进行飞秒激光辅助白内障手术。采用线性回归分析，以手术类型（飞秒激光辅助白内障手术与传统超声乳化白内障吸除术）作为暴露因素，累积分散能量（CDE）作为结果变量。年龄、手术医生、患眼侧别和手术顺序（第一只眼与第二只眼）作为协变量。
结果
共有1159例手术符合纳入标准。队列的平均年龄为70.6（标准差8.6）岁，590例（51%）由手术医生1进行，582例（50%）为右眼。总体而言，与传统超声乳化白内障吸除术相比，飞秒激光辅助白内障手术导致的累积分散能量显著更低（β = 0.89，95%可信区间0.83，0.95）。按患眼侧别和手术医生分层时，手术医生1进行的左眼飞秒激光辅助白内障手术与传统超声乳化白内障吸除术相比，累积分散能量更低（β = 0.76，95%可信区间0.66，0.87），但手术医生1进行的右眼手术（β = 0.92，95%可信区间0.79，1.07）或手术医生2或3进行的手术则不然。
结论
在爱尔康LenSx平台上使用飞秒激光辅助白内障手术，在某些情况下与传统超声乳化白内障吸除术相比，超声乳化能量略有降低。有必要进一步研究评估最佳激光设置和手术技术。
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