Ma Ling-Yun, Rong Ao, Jiang Yi, Deng Shu-Ya
Department of Ophthalmology, Tongji Hospital Affiliated to Tongji University, Shanghai, 200065, China.
Shanghai Xin Shi Jie Eye Hospital, Shanghai, 200050, China.
Ophthalmol Ther. 2021 Mar;10(1):137-150. doi: 10.1007/s40123-020-00326-x. Epub 2021 Jan 19.
This study aimed to compare the short-term changes in retinal and choroid thickness in diabetic patients after femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification (PE) surgery.
A total of 47 eyes in the PE group and 44 eyes in the FLACS group were included. All patients underwent measurement of central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) before and after surgery using optical coherence tomography (OCT).
The effective phaco time (EPT) in the FLACS group was significantly reduced. The BCVA differed significantly between the two groups at 1 week and 1 month after surgery. The CMT in both groups increased at 1 week after the operation. It did not return to the preoperative level until month 12 in the PE group. In the FLACS group, the CMT began to decrease at month 3 and recovered to the preoperative level at month 12. The SFCT of the two groups increased at week 1; it began to decrease at month 6 in the PE group but did not recover to the preoperative level until month 12. The SFCT in the FLACS group recovered to preoperative levels at month 6. In the PE group, baseline CMT values predicted CMT change at week 1 and months 1, 3 and 12 after surgery. In the FLACS group, baseline CMT predicted CMT changes at week 1, month 1 and month 3. In the FLACS group, EPT predicted SFCT change at month 3.
FLACS is safe and effective in patients with no fundus change or mild diabetic retinopathy. It has advantages in effectively reducing EPT, achieving good vision earlier and promoting faster recovery of the retinal and choroidal thickness. Preoperative CMT is a significant predictor of CMT changes in the early period after FLACS.
本研究旨在比较飞秒激光辅助白内障手术(FLACS)和超声乳化白内障吸除术(PE)后糖尿病患者视网膜和脉络膜厚度的短期变化。
PE组纳入47只眼,FLACS组纳入44只眼。所有患者在手术前后使用光学相干断层扫描(OCT)测量中心黄斑厚度(CMT)和黄斑中心凹下脉络膜厚度(SFCT)。
FLACS组的有效超声乳化时间(EPT)显著缩短。两组术后1周和1个月时的最佳矫正视力(BCVA)差异显著。两组术后1周时CMT均增加。PE组直到术后12个月CMT才恢复到术前水平。在FLACS组,CMT在术后3个月开始下降,并在术后12个月恢复到术前水平。两组的SFCT在术后1周时增加;PE组在术后6个月开始下降,但直到术后12个月才恢复到术前水平。FLACS组的SFCT在术后6个月恢复到术前水平。在PE组,基线CMT值可预测术后1周以及术后1、3和12个月时的CMT变化。在FLACS组,基线CMT可预测术后1周、1个月和3个月时的CMT变化。在FLACS组,EPT可预测术后3个月时的SFCT变化。
对于无眼底改变或轻度糖尿病视网膜病变的患者,FLACS安全有效。它在有效缩短EPT、更早获得良好视力以及促进视网膜和脉络膜厚度更快恢复方面具有优势。术前CMT是FLACS术后早期CMT变化的重要预测指标。