Zhu Yanan, Shi Kexin, Yao Ke, Wang Yuyan, Zheng Sifan, Xu Wen, Chen Peiqing, Yu Yibo, Shentu Xingchao
The Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China.
Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China.
Front Med (Lausanne). 2021 Mar 11;8:640269. doi: 10.3389/fmed.2021.640269. eCollection 2021.
To compare the parameters of capsulorrhexis and intraocular lens decentration after femtosecond laser capsulotomy and manual continuous curvilinear capsulorrhexis in high myopic patients with cataracts. This is a prospective consecutive non-randomized comparative cohort study. Selected patients with axial length > 26.0 mm were divided into femtosecond laser capsulotomy (FS) group and manual continuous curvilinear capsulorrhexis (CCC) group. Five experienced phacoemulsification surgeons conducted all surgeries. Intraoperative complications and post-operative anterior segment photography were recorded. Intraocular lens decentration, area of capsulorrhexis, circularity, and capsule overlap were measured at 1 week, 1 month, and 2 years after surgery. Between group differences of parameters were determined with independent-sample -test or the Mann-Whitney -test, analysis of variance test, Pearson chi-square test, and Spearman rank correlation test. The study included 142 eyes (108 patients), 68 eyes in the FS group, and 74 eyes in the CCC group. At 1 week, 1 month, and 2 years after surgery, the area of capsulorrhexis in the CCC group was significantly larger than in the FS group ( < 0.05), while no significant difference was noted in circularity values. The complete overlap ratio in the FS group was significantly higher than that in the CCC group ( < 0.05) at each measured timepoint. Significant correlations were noted between the anterior chamber depth and the area of capsulorrhexis in the CCC group ( = 0.25, = 0.04), but did not correlate in the FS group ( > 0.05). In patients with an anterior chamber depth >3 mm, the capsule-intraocular lens (IOL) overlap of the CCC group was less than that of the FS group at all measured timepoints after surgery ( < 0.05). Meanwhile, the IOL decentration in the CCC group was significantly greater than that of the FS group in those patients at 2 years after surgery ( < 0.05). In high myopic patients with cataracts, with anterior chamber depth more than 3 mm, femtosecond laser capsulotomy can achieve better capsulorrhexis sizing and centering. Due to more precise capsulotomy and a better capsule-IOL overlap in the FS group, femtosecond laser capsulotomy resulted in better long-term centration of the IOL.
比较飞秒激光白内障囊切开术和手法连续环形撕囊术后高度近视白内障患者的撕囊参数和人工晶状体偏心情况。这是一项前瞻性连续非随机对照队列研究。将眼轴长度>26.0mm的入选患者分为飞秒激光白内障囊切开术（FS）组和手法连续环形撕囊术（CCC）组。5名经验丰富的超声乳化手术医生进行所有手术。记录术中并发症和术后眼前节照相。在术后1周、1个月和2年测量人工晶状体偏心度、撕囊面积、圆形度和囊膜重叠情况。采用独立样本t检验或曼-惠特尼U检验、方差分析、Pearson卡方检验和Spearman秩相关检验确定组间参数差异。该研究纳入142只眼（108例患者），FS组68只眼，CCC组74只眼。术后1周、1个月和2年，CCC组的撕囊面积显著大于FS组（P<0.05），而圆形度值无显著差异。在每个测量时间点，FS组的完全重叠率显著高于CCC组（P<0.05）。CCC组前房深度与撕囊面积之间存在显著相关性（r=0.25，P=0.04），而FS组无相关性（P>0.05）。在前房深度>3mm的患者中，术后所有测量时间点CCC组的囊膜-人工晶状体（IOL）重叠均小于FS组（P<0.05）。同时，在这些患者中，术后2年CCC组的IOL偏心度显著大于FS组（P<0.05）。在高度近视白内障患者中，前房深度超过3mm时，飞秒激光白内障囊切开术可实现更好的撕囊大小和居中。由于FS组的囊切开术更精确且囊膜-IOL重叠更好，飞秒激光白内障囊切开术导致IOL长期居中更好。
