飞秒激光辅助白内障手术与传统超声乳化白内障吸除术的比较：应用衍射型多焦点人工晶状体的屈光和像差结果。

Femtosecond laser-assisted cataract surgery versus conventional phacoemulsification: Refractive and aberrometric outcomes with a diffractive multifocal intraocular lens.

机构信息

Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.

出版信息

J Cataract Refract Surg. 2019 Jan;45(1):21-27. doi: 10.1016/j.jcrs.2018.08.032. Epub 2018 Nov 10.

DOI:10.1016/j.jcrs.2018.08.032

PMID:30424904

Abstract

PURPOSE

To compare the outcomes of conventional phacoemulsification and femtosecond laser-assisted cataract surgery followed by multifocal intraocular lens (IOL) implantation.

SETTING

Asan Medical Center, Seoul, South Korea.

DESIGN

Retrospective case series.

METHODS

Depending on their preference, patients had femtosecond laser-assisted cataract surgery or conventional phacoemulsification. Patients in the femtosecond group with corneal astigmatism greater than 0.75 diopter also had arcuate keratotomy. All eyes had multifocal IOL implantation. One month after treatment, the uncorrected distance and near visual acuities, spherical equivalent, corneal and refractive astigmatism, aberrometry results, and questionnaire results were compared between groups. Correlations between target-induced astigmatism (TIA) and surgically induced astigmatism (SIA) were also compared between the groups.

RESULTS

The femtosecond group comprised 17 patients (23 eyes), with arcuate keratotomy performed in 14 eyes. The conventional phacoemulsification group comprised 22 patients (26 eyes). In the femtosecond group, the difference in corneal astigmatism between preoperatively and postoperatively was statistically significant. The correlation between TIA and SIA was greater in the femtosecond group. Corneal root-mean-square higher-order aberrations (RMS HOAs) (P < .01) and total trefoil (P = .043) were significantly higher in the femtosecond laser group. However, internal total RMS (P = .05), tilt (P = .041), and RMS HOAs (P = .047) were significantly lower in the femtosecond group. Satisfaction scores were significantly higher in the femtosecond group.

CONCLUSIONS

Astigmatic change was more predictable in the femtosecond laser-assisted cataract surgery group. Internal aberrations, including total RMS, tilt, and RMS HOAs, were lower in the femtosecond group, and patients in that group were more satisfied.

摘要

目的

比较传统超声乳化白内障吸除术与飞秒激光辅助白内障手术后植入多焦点人工晶状体（IOL）的结果。

背景

韩国首尔峨山医疗中心。

设计

回顾性病例系列。

方法

根据患者的偏好，患者接受飞秒激光辅助白内障手术或传统超声乳化白内障吸除术。飞秒组中角膜散光大于 0.75 屈光度的患者还进行了弧形角膜切开术。所有眼均植入多焦点 IOL。治疗 1 个月后，比较两组间的未矫正远距和近距视力、等效球镜、角膜和屈光性散光、像差测量结果和问卷调查结果。还比较了两组间目标诱导散光（TIA）与手术诱导散光（SIA）之间的相关性。

结果

飞秒组包括 17 例（23 只眼），其中 14 只眼行弧形角膜切开术。传统超声乳化组包括 22 例（26 只眼）。飞秒组中，术前与术后角膜散光差异有统计学意义。飞秒组中 TIA 与 SIA 的相关性更强。飞秒激光组角膜均方根高阶像差（RMS HOAs）（P<.01）和总三叶（P=.043）明显更高。然而，飞秒组的总 RMS（P=.05）、倾斜（P=.041）和 RMS HOAs（P=.047）明显较低。飞秒组的满意度评分明显更高。