Salgado Ramiro, Torres Paulo F, Marinho Antonio
Departamento de Oftalmologia do Hospital da Arrábida, Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Vila Nova de Gaia, Porto, Portugal.
Departamento de Oftalmologia do Hospital da Prelada, Universidade do Porto, Porto, Portugal.
Clin Ophthalmol. 2023 Jan 24;17:331-339. doi: 10.2147/OPTH.S399788. eCollection 2023.
To compare the pupil changes in low-energy femtosecond laser-assisted cataract surgery (FLACS) with conventional phacoemulsification (CP) intraindividually.
A retrospective review of registered surgical data from patients that undergone uncomplicated cataract surgery in a single centre, with randomly assigned femtosecond laser-assisted cataract surgery (FLACS) to one eye and conventional phacoemulsification (CP) to the other, was performed. The recorded pupil images were evaluated at pre and post laser treatment (after suction release) and at several surgical timepoints for both techniques (FLACS and CP). Pupil areas were calculated and compared in the same eye undergone FLACS (pre vs post laser treatment), between eyes (CP vs FLACS) in the same patient and between groups. Subgroups were built regarding age and ocular comorbidity.
This study involved a total of 164 eyes of 82 patients (55 female, 27 male). No statistical differences regarding the total duration of surgery (p=0.805) between FLACS and CP. Pupil measurements between pre and post laser treatment in the FLACS group showed no statistically significant differences (p=0.107). The mean change in pupil area from the beginning until the end of surgery (total variation) was 6.59±2.08 mm in the FLACS group and 6.67±2.13 mm in the CP group, associated to less narrowing of pupil area with FLACS, although not statistically significant (p=0.080). Comorbidity group analysis revealed less, but not significant, pupil narrowing with the FLACS technique (p=0.071). No statistically significant differences between FLACS and CP concerning age subgroups were registered.
This study shows no significant pupil changes, namely myosis, after low-energy FLACS pre-treatment. Comparison between techniques showed less pupil variation in FLACS as compared to CP, more markedly in eyes with comorbidities (particularly with shallow anterior chamber), although non-statistically significant.
在个体内比较低能量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（CP）时的瞳孔变化。
对在单一中心接受无并发症白内障手术患者的登记手术数据进行回顾性研究，随机将一只眼分配接受飞秒激光辅助白内障手术（FLACS），另一只眼接受传统超声乳化白内障吸除术（CP）。记录术前、激光治疗后（吸除结束后）以及两种技术（FLACS和CP）的几个手术时间点的瞳孔图像。计算并比较同一眼接受FLACS手术时（激光治疗前后）、同一患者两眼之间（CP与FLACS）以及组间的瞳孔面积。根据年龄和眼部合并症构建亚组。
本研究共纳入82例患者的164只眼（女性55例，男性27例）。FLACS与CP之间手术总时长无统计学差异（p = 0.805）。FLACS组激光治疗前后的瞳孔测量无统计学显著差异（p = 0.107）。FLACS组从手术开始到结束时瞳孔面积的平均变化（总变化量）为6.59±2.08mm²，CP组为6.67±2.13mm²，FLACS组瞳孔面积缩小较少，尽管无统计学显著差异（p = 0.080）。合并症亚组分析显示，FLACS技术导致的瞳孔缩小较少，但无统计学意义（p = 0.071）。FLACS与CP在年龄亚组方面无统计学显著差异。
本研究表明低能量FLACS预处理后无显著的瞳孔变化，即瞳孔缩小。技术比较显示，与CP相比，FLACS的瞳孔变化较小，在合并症患者（尤其是前房浅的患者）眼中更为明显，尽管无统计学意义。
