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白内障手术中的纳米激光及其对角膜内皮的影响。

Nanolaser in cataract surgery and its impact on corneal endotelium.

作者信息

Juhás T, Juhás Ml T

出版信息

Cesk Slov Oftalmol. 2019 Winter;75(5):268-271. doi: 10.31348/2019/5/4.

Abstract

PURPOSE

To compare safety and efficacy of new nanolaser photofragmentation technique with standard ultrasound phacoemulsification cataract surgery technique. Metods: A group of 20 patients - 40 eyes who underwent bilateral cataract surgery, one eye with ultrasound phacoemulsification (group I), n = 20 fellow eye with nanosecond laser framentation (group II ). Lens Opacities Classification System III was used to classify cataract stage. All 40 eyes had stage III cataract, Nucleus Opalescence was NO2 - NO3. Uncorrected visual acuity (UCVA), endothelial cells density (DEC), hexagonal cells rate, index of endothelial cells pleomorfism, and corneal thickness were evaluated prior to surgery and at day 7 follow up.

RESULTS

All 40 eyes had uneventful surgery,without complications. Preoperative UCVA in group I was 0,70±0,07 and 0,68 ± 0,10 in group II. At follow up check 7 days after surgery UCVA was 0,98 ± 0,05 in group 1 and 0,98 ± 0,04 in group II (p-NS). The mean DEC (cells/mm2) before surgery was 2508 ± 205,54 in group 1 and 2472 ± 287,85 in group II. After surgery density decreased to 2024,92±271,50 in group 1 and 2138,5 ± 390,85 in group II. Difference in endothelial cells decrease between groups showed no statistical significance. There was no statistical significance in differences of hexagonal cells rate and corneal thickness between both groups pre and postoperatively.

CONCLUSION

Nanolaser lens photofragmentation and ultrasound phacoemulsification can be considered equal regarding impact on endothelial cells.

摘要

目的

比较新型纳米激光光破碎技术与标准超声乳化白内障手术技术的安全性和有效性。方法:一组20例患者(40只眼)接受了双侧白内障手术,一只眼采用超声乳化术(第一组),n = 20,另一只眼采用纳秒激光破碎术(第二组)。使用晶状体混浊分级系统III对白内障分期进行分类。所有40只眼均为III期白内障,核混浊度为NO2 - NO3。在手术前及术后第7天随访时评估未矫正视力(UCVA)、内皮细胞密度(DEC)、六边形细胞率、内皮细胞多形性指数和角膜厚度。

结果

所有40只眼手术均顺利,无并发症。第一组术前UCVA为0.70±0.07,第二组为0.68±0.10。术后7天随访时,第一组UCVA为0.98±0.05,第二组为0.98±0.04(p无统计学意义)。第一组手术前平均DEC(细胞/mm²)为2508±205.54,第二组为2472±287.85。术后第一组密度降至2024.92±271.50,第二组降至2138.5±390.85。两组间内皮细胞减少的差异无统计学意义。两组术前和术后六边形细胞率和角膜厚度的差异均无统计学意义。

结论

就对内皮细胞的影响而言,纳米激光晶状体光破碎术和超声乳化术可被视为等效。

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