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高度近视白内障患者的 FLACS 与传统超声乳化术的对比研究。

Comparative study of FLACS vs conventional phacoemulsification for cataract patients with high myopia.

机构信息

From the Eye Institute, Affiliated Hospital of Nantong University, Nantong, China (Zhao, Tan, Zhang, Liang, Ji, Guan); Yixing People's Hospital, Wuxi, China (Hao).

出版信息

J Cataract Refract Surg. 2024 Jun 1;50(6):624-630. doi: 10.1097/j.jcrs.0000000000001425.

Abstract

PURPOSE

To compare the short-term changes in cornea, retina, and choroid of femtosecond laser-assisted cataract surgery (FLACS) with conventional phacoemulsification (CPS) in high myopia patients with cataract.

SETTING

Affiliated Hospital of Nantong University, Jiangsu Province, China.

DESIGN

Prospective single-center study.

METHODS

Demographics, ocular clinical features, ultrasound power, absolute phacoemulsification time, and effective phacoemulsification time were recorded for each patient. Endothelial cell density (ECD), central corneal thickness (CCT), corrected distance visual acuity (CDVA), intraocular pressure (IOP), center foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) were evaluated preoperatively and at 1 week, 1 month, and 3 months postoperatively. Intraoperative parameters and intraoperative/postoperative complications were recorded.

RESULTS

97 eyes (46 eyes and 51 eyes in the FLACS and CPS groups, respectively) were included and analyzed. Effective phacoemulsification time was lower in the FLACS group compared with the CPS group ( P < .05). The increase in CCT was significantly lower in the FLACS group compared with the CPS group at 1 week and 1 month ( P < .05). CDVA and IOP were similar in both groups at the final visit ( P > .05). The ECD decreased was lower among CPS patients compared with FLACS patients. CFT, SFCT, and CVI increase in both groups but were increased more in the CPS group with high myopia patients. No serious complications occurred in either group.

CONCLUSIONS

FLACS is a more safety and effective in cataract patients with high myopia. It has advantages in effectively reducing EPT and promoting faster recovery of the cornea, macular, and choroidal thickness.

摘要

目的

比较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(CPS)治疗高度近视白内障患者短期的角膜、视网膜和脉络膜变化。

设置

中国江苏省南通大学附属医院。

设计

前瞻性单中心研究。

方法

记录每位患者的人口统计学、眼部临床特征、超声能量、绝对超声乳化时间和有效超声乳化时间。术前及术后 1 周、1 个月和 3 个月评估内皮细胞密度(ECD)、中央角膜厚度(CCT)、矫正远视力(CDVA)、眼压(IOP)、中心黄斑厚度(CFT)、黄斑下脉络膜厚度(SFCT)和脉络膜血管指数(CVI)。记录术中参数和术中/术后并发症。

结果

纳入并分析了 97 只眼(FLACS 组 46 只眼,CPS 组 51 只眼)。FLACS 组的有效超声乳化时间明显低于 CPS 组(P<0.05)。FLACS 组术后 1 周和 1 个月时 CCT 增加明显低于 CPS 组(P<0.05)。两组最终随访时 CDVA 和 IOP 相似(P>0.05)。CPS 组的 ECD 下降低于 FLACS 组。两组的 CFT、SFCT 和 CVI 均增加,但高度近视患者的 CPS 组增加更多。两组均未发生严重并发症。

结论

FLACS 治疗高度近视白内障患者更安全有效。它在有效减少 EPT 和促进角膜、黄斑和脉络膜厚度更快恢复方面具有优势。

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