Reddy Jagadesh C, Devta Soumya, Vupparaboina Kiran Kumar, Ali Mohammad Hasnat, Vaddavalli Pravin K
Cataract and Refractive Services, Cornea Institute, L V Prasad Eye Institute (LVPEI), Hyderabad 500034, India.
Senior Scientific Officer, Srujana Centre for Innovation, L V Prasad Eye Institute (LVPEI), Hyderabad 500034, India.
Int J Ophthalmol. 2021 Jan 18;14(1):76-82. doi: 10.18240/ijo.2021.01.11. eCollection 2021.
To compare the difference of capsulotomy produced by precision pulse capsulotomy (PPC), manual (M-CCC), and femtosecond laser assisted capsulotomy (FLAC) in relation to intraocular lens (IOL) centration, circularity and its effect on visual outcomes.
Prospective, non-randomized comparative study conducted at LV Prasad Eye Institute, Hyderabad, India. Sixty eyes of 52 patients were grouped into 3 (FLAC, PPC and M-CCC) based on capsulotomy techniques used. Twenty consecutive eyes with uneventful phacoemulsification and with no comorbidities affecting the capsulotomy or visual outcome were included in each group. The main outcome measure was IOL centration in relation to capsulotomy and pupil. Secondary outcome measures were post-operative visual acuity, manifest refraction and aberration profile between groups.
At 5wk the visual, refractive outcomes and endothelial cell density were comparable between the 3 groups. The median circularity index of FLAC was statistically significantly different to M-CCC or PPC (1-10) groups (<0.01) but PPC (11-20) was comparable to FLAC. Decentration of IOL center in relation to capsulotomy was seen only between the PPC (1-10) group and FLAC group (=0.02). The IOL was well centered in relation to the pupil in all the groups (=0.46). The quality of vision parameters like the higher order aberrations, spherical aberration, coma, trefoil, modular transfer function, and Strehl ratio were comparable between the groups.
Our study shows that despite differences in the morphology of capsulotomy produced by PPC, M-CCC, FLAC a well-centered IOL can be achieved. The measured capsular morphology parameters do not affect visual outcomes.
比较精准脉冲截囊术（PPC）、手法（M-CCC）和飞秒激光辅助截囊术（FLAC）所产生的晶状体囊膜切开术在人工晶状体（IOL）居中、圆形度及其对视觉结果的影响方面的差异。
在印度海得拉巴的LV普拉萨德眼科研究所进行前瞻性、非随机对照研究。根据所使用的截囊术技术，将52例患者的60只眼分为3组（FLAC、PPC和M-CCC）。每组纳入20只连续的、行超声乳化术过程顺利且无影响截囊术或视觉结果的合并症的眼睛。主要观察指标是IOL相对于囊膜切开术和瞳孔的居中情况。次要观察指标是各组之间的术后视力、明显验光和像差情况。
在5周时，3组之间的视觉、屈光结果和内皮细胞密度具有可比性。FLAC组的中位圆形度指数与M-CCC或PPC（1-10）组相比有统计学显著差异（<0.01），但PPC（11-20）组与FLAC组相当。仅在PPC（1-10）组和FLAC组之间观察到IOL中心相对于囊膜切开术的偏心（=0.02）。在所有组中，IOL相对于瞳孔的居中情况良好（=0.46）。各组之间的视力参数质量，如高阶像差、球差、彗差、三叶草像差、调制传递函数和斯特列尔比具有可比性。
我们的研究表明，尽管PPC、M-CCC、FLAC所产生的囊膜切开术形态存在差异，但仍可实现IOL良好居中。所测量的晶状体囊膜形态参数不影响视觉结果。
