Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdystreet, Roshdy, Alexandria, Egypt.
BMC Ophthalmol. 2020 Jan 2;20(1):1. doi: 10.1186/s12886-019-1277-9.
To compare the visual and refractive outcomes of femtosecond laser assisted cataract surgery (FLACS) using Victus platform (Technolas Bausch and Lomb (B&L), Munich, Germany) and conventional phacoemulsification cataract surgery (CPCS).
A retrospective study of 100 eyes operated for cataract. FLACS was performed in 50 eyes and CPCS was done in another 50 eyes. Preoperative and 6 months postoperative visual and refractive evaluation (efficacy, safety, predictability, and surgically induced astigmatism) as well as higher-order aberrations were analyzed. Efficacy index which equals post-operative mean of uncorrected distance visual acuity (UDVA) divided by preoperative mean corrected distance visual acuity (CDVA) was calculated in both groups. Safety index equals post-operative mean of corrected distance visual acuity (CDVA) divided by preoperative mean CDVA.
Logarithm of the Minimum Angle of Resolution (LogMAR), UDVA improved in both groups after surgery (p < 0.05). It was 0.23 ± 0.20 and 0.291 ± 0.311 log MAR in FLACS and CPCS groups respectively. Safety index was 1.777 in FLACS group and 1.744 in CPCS groups showing high degree of safety of both measures. Mean surgically induced astigmatism (SIA) was 0.35 ± 0.67 D and 0.901 ± 0.882 D in FLACS and CPCS groups respectively (p = 0.015). The post-operative comparison between both groups was in favor of CPCS group vs. FLACS group regarding total aberrations (0.563 ± 0.386 vs. 0.91 ± 1.20) (p = 0.03), while low order aberrations were significantly less in FLACS group vs. CPCS group (0.64 + 0.63 vs. 2.07 + 3.15) (p = 0.027). RMS high order aberration was higher in FLACS group vs. CPCS group but of no statistical significance 0.54 ± 0.96 vs. 0.328 ± 0.360 (p = 0.082).
Femtosecond laser -assisted cataract surgery was a safe and precise procedure but enhanced visual outcomes only minimally when compared to conventional cataract surgery in experienced hands. Both FLACS and manual surgeries can achieve a high efficacy, predictability and safety with slight superior outcomes in FLACS.
PACTR201804003256258 (date: 27 Mar 2018) Available at: https://pactr.samrc.ac.za/.
比较使用 Victus 平台（德国慕尼黑的 Technolas Bausch and Lomb（B&L）的飞秒激光辅助白内障手术（FLACS）和传统的超声乳化白内障手术（CPCS）的视觉和屈光结果。
回顾性研究了 100 只接受白内障手术的眼睛。50 只眼行 FLACS，50 只眼行 CPCS。分析术前和术后 6 个月的视力和屈光评估（疗效、安全性、可预测性和手术诱导的散光）以及高阶像差。在两组中均计算等于术后平均未矫正距离视力（UDVA）除以术前平均矫正距离视力（CDVA）的疗效指数。安全性指数等于术后平均矫正距离视力（CDVA）除以术前平均 CDVA。
两组术后 LogMAR（最小角分辨率对数）、UDVA 均有改善（p<0.05）。FLACS 组和 CPCS 组分别为 0.23±0.20 和 0.291±0.311 logMAR。FLACS 组的安全性指数为 1.777，CPCS 组为 1.744，均显示出高度的安全性。FLACS 组和 CPCS 组的平均手术诱导散光（SIA）分别为 0.35±0.67 D 和 0.901±0.882 D（p=0.015）。两组间术后比较，CPCS 组优于 FLACS 组，总像差（0.563±0.386 vs. 0.91±1.20）（p=0.03），而低阶像差 FLACS 组明显低于 CPCS 组（0.64+0.63 vs. 2.07+3.15）（p=0.027）。FLACS 组的 RMS 高阶像差高于 CPCS 组，但无统计学意义（0.54±0.96 vs. 0.328±0.360）（p=0.082）。
飞秒激光辅助白内障手术是一种安全、精确的手术，但与经验丰富的医生进行的传统白内障手术相比，仅能轻微改善视觉效果。FLACS 和手动手术都可以达到高疗效、可预测性和安全性，FLACS 略占优势。
PACTR201804003256258（日期：2018 年 3 月 27 日）可在以下网址获得：https://pactr.samrc.ac.za/。
