Hansen Brock, Blomquist Preston H, Ririe Peter, Pouly Severin, Nguyen Chan, Petroll W Matthew, McCulley James P
From the Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Cataract Refract Surg. 2020 Sep;46(9):1273-1277. doi: 10.1097/j.jcrs.0000000000000253.
To compare the effectiveness of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPS) by resident surgeons.
Parkland Memorial Health and Hospital System, Dallas, Texas, USA.
Prospective randomized study.
All surgeries to be performed by postgraduate year 3 and year 4 residents from October 2015 through June 2017 were eligible for inclusion. Patients were required to complete postoperative day 1, week 1, month 1, and month 3 visits. Specular microscopy was performed preoperatively and postoperatively. Surgeries were filmed, and each step was timed and compared. Surgeon and patient surveys were filled out postoperatively.
Of the 135 eyes of 96 subjects enrolled in the study, 64 eyes received FLACS and 71 eyes received CPS. There was no significant difference in corrected distance visual acuity (CDVA), either preoperatively or at the postoperative day 1, week 1, month 1, or month 3 visits (P = .469, .539, .701, .777, and .777, respectively). Cumulated dissipated energy and irrigation fluid usage were not different between FLACS and CPS (P = .521 and .368, respectively), nor was there a difference in the reduction of endothelial cell counts postoperatively (P = .881). Wound creation (P = .014), cortical cleanup (P = .009), and IOL implantation (P = .031) were faster in the CPS group. Survey results indicated that the overall patient experience was similar for FLACS and CPS.
This first prospective randomized trial evaluating resident-performed FLACS shows that, in resident hands, FLACS provides similar results to CPS regarding visual acuity, endothelial cell loss, operative time, patient satisfaction, and surgical complication rate.
比较住院医师进行飞秒激光辅助白内障手术（FLACS）和传统超声乳化白内障手术（CPS）的效果。
美国得克萨斯州达拉斯市帕克兰纪念健康与医院系统。
前瞻性随机研究。
纳入2015年10月至2017年6月期间由三年级和四年级住院医师进行的所有手术。患者需完成术后第1天、第1周、第1个月和第3个月的随访。术前和术后进行镜面显微镜检查。手术过程进行拍摄，对每个步骤进行计时并比较。术后填写外科医生和患者调查问卷。
在该研究纳入的96名受试者的135只眼中，64只眼接受了FLACS，71只眼接受了CPS。术前及术后第1天、第1周、第1个月或第3个月随访时，矫正远视力（CDVA）无显著差异（P分别为0.469、0.539、0.701、0.777和0.777）。FLACS和CPS之间的累积消散能量和冲洗液用量无差异（P分别为0.521和0.368），术后内皮细胞计数减少也无差异（P = 0.881）。CPS组在伤口创建（P = 0.014）、皮质清理（P = 0.009）和人工晶状体植入（P = 0.031）方面更快。调查结果表明，FLACS和CPS的总体患者体验相似。
这项评估住院医师进行的FLACS的首个前瞻性随机试验表明，在住院医师手中，FLACS在视力、内皮细胞丢失、手术时间、患者满意度和手术并发症发生率方面与CPS效果相似。
