From the Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), Eye Clinic, University of Florence, Florence, Italy.
J Cataract Refract Surg. 2020 Dec;46(12):1604-1610. doi: 10.1097/j.jcrs.0000000000000341.
To compare the postoperative outcomes between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification in eyes with shallow anterior chamber depth (ACD).
Eye Clinic, NEUROFARBA Department, University of Florence, Italy.
Prospective case series.
Forty eyes of 40 patients with senile cataract and true ACD less than 2.00 mm underwent FLACS (femto group, n = 20) or manual phacoemulsification (phacoemulsification group, n = 20). Preoperatively and 1 week and 1 month and 6 months postoperatively, central corneal thickness (CCT) and endothelial cell density were evaluated; basal epithelial cell (BEC) and Langerhans dendritic cell (LDC) densities and keratocyte activation were assessed using in vivo corneal confocal microscopy. Intraoperative parameters such as cumulative dissipated energy (CDE) and ultrasound (US) power were recorded.
Endothelial cell loss (ECL) was significantly lower in the femto group at all timepoints (P ≤ .001). In the phacoemulsification group, the CCT was significantly higher 1 week (P < .001) and 1 month (P < .001) postoperatively than preoperatively; conversely, in the femto group, it was higher only after 1 week (P < .001). BECs and LDCs significantly increased at 1 postoperative week (P < .001), returning to preoperative values after 1 month in both groups. Keratocyte activation remained significantly higher at 1 postoperative month only in the phacoemulsification group (P = .005). CDE and US power were lower in the femto group (P = .017 and P = .001, respectively); they were correlated with ECL (r = 0.662, P = .000; r = 0.389, P = .013).
In eyes with shallow ACD, FLACS was a safe and an effective technique, significantly reducing the postoperative ECL and corneal inflammation compared with conventional phacoemulsification.
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（phacoemulsification）在浅前房深度（ACD）眼中的术后效果。
意大利佛罗伦萨大学神经眼科诊所。
前瞻性病例系列。
40 例（40 只眼）老年性白内障合并真正 ACD 小于 2.00mm 的患者接受了 FLACS（飞秒组，n = 20）或手动 phacoemulsification（超声乳化组，n = 20）。术前及术后 1 周、1 个月和 6 个月，评估中央角膜厚度（CCT）和内皮细胞密度；使用活体角膜共聚焦显微镜评估基底上皮细胞（BEC）和朗格汉斯树突状细胞（LDC）密度和角膜细胞激活。记录术中参数，如累积消散能量（CDE）和超声（US）功率。
飞秒组在所有时间点的内皮细胞丢失（ECL）均显著降低（P ≤.001）。在超声乳化组，术后 1 周（P <.001）和 1 个月（P <.001）时 CCT 显著高于术前；相反，在飞秒组中，仅在术后 1 周时（P <.001）升高。术后 1 周 BEC 和 LDC 显著增加（P <.001），两组均在术后 1 个月恢复至术前水平。仅在超声乳化组，术后 1 个月角膜细胞激活仍显著升高（P =.005）。飞秒组的 CDE 和 US 功率较低（P =.017 和 P =.001）；它们与 ECL 相关（r = 0.662，P =.000；r = 0.389，P =.013）。
在浅前房深度的眼中，FLACS 是一种安全有效的技术，与传统的超声乳化白内障吸除术相比，可显著减少术后 ECL 和角膜炎症。
