Dardenne Eye Hospital, Bonn, Germany.
Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany.
PLoS One. 2021 May 17;16(5):e0251549. doi: 10.1371/journal.pone.0251549. eCollection 2021.
To assess potential changes in pupil size during femtosecond laser-assisted cataract surgery (FLACS) using a low-energy laser system.
The pupil sizes of eyes undergoing FLACS were measured using the Ziemer LDV Z8 by extracting images from the laser software after each of the following steps: application of suction, lens fragmentation, and capsulotomy. Furthermore, the pupil diameters were measured based on preoperative surgical microscope images and after releasing the suction. Paired t-test and the two one-sided tests (TOST) procedure were used for statistical analyses. The horizontal and vertical pupil diameters were compared in each of the steps with preoperative values.
Data were available for 52 eyes (52 patients, mean age 73.4 years, range 51-87 years). The equivalence between mean preoperative pupil size and status immediately after femtosecond laser treatment was confirmed (p<0.001; 95% confidence interval [-0.0637, 0.0287] for horizontal and p<0.001; 95% CI [-0.0158, 0.0859] for vertical diameter). There was statistically significant horizontal and vertical enlargement of pupil diameters between 0.15 and 0.24 mm during the laser treatment steps as compared with preoperative values (all p values <0.001).
No progressive pupil narrowing was observed using low-energy FLACS. Although a suction-induced, slight increase in pupil area became apparent, this effect was completely reversible after removing the laser interface.
使用低能量激光系统评估飞秒激光辅助白内障手术（FLACS）过程中瞳孔大小的潜在变化。
在进行 FLACS 时，使用 Ziemer LDV Z8 通过从激光软件中提取图像来测量眼睛的瞳孔大小，这些图像是在以下步骤中的每一步之后提取的：应用吸力、晶状体碎块和囊切开术。此外，还根据术前手术显微镜图像和释放吸力后测量瞳孔直径。使用配对 t 检验和双边检验（TOST）程序进行统计分析。在每个步骤中，将水平和垂直瞳孔直径与术前值进行比较。
共有 52 只眼（52 例患者，平均年龄 73.4 岁，范围 51-87 岁）的数据可用。确认了平均术前瞳孔大小与飞秒激光治疗后即刻状态之间的等效性（p<0.001；水平方向的 95%置信区间[-0.0637，0.0287]，垂直方向的 p<0.001；95%CI[-0.0158，0.0859]）。与术前值相比，在激光治疗步骤中，瞳孔直径在 0.15 至 0.24 毫米之间出现了统计学上显著的水平和垂直扩大（所有 p 值均<0.001）。
使用低能量 FLACS 未观察到瞳孔逐渐变窄。虽然吸力引起的瞳孔区域轻微增加变得明显，但在去除激光界面后，这种效应是完全可逆的。
