Saevit Eye Hospital, Goyang 10447, Republic of Korea.
Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore.
Biomolecules. 2024 Mar 7;14(3):318. doi: 10.3390/biom14030318.
This study was conducted to evaluate the effects of different capsulotomy and fragmentation energy levels on the production of oxidative free radicals following femtosecond laser-assisted cataract surgery (FLACS) with a low-energy platform.
The experimental study included 60 porcine eyes (12 groups). In each group, capsulotomies with 90% or 150% energy, and fragmentations with 90%, 100%, or 150% energy or 150% with high spot density, respectively, were performed. Control samples were obtained from non-lasered eyes at the beginning (five eyes) and end (five eyes) of the experiment. In the clinical study, 104 eyes were divided into 5 groups, and they received conventional phacoemulsification (20 eyes), FLACS with 90% capsulotomy and 100% fragmentation energy levels without NSAIDs (16 eyes), FLACS with 90% (26 eyes) or 150% (22 eyes) capsulotomy energy levels, respectively, with a 100% fragmentation energy level and NSAIDs, and FLACS with 90% capsulotomy and 150% fragmentation energy levels and NSAIDs (20 eyes). Aqueous samples were analyzed for their malondialdehyde (MDA) and superoxide dismutase (SOD) levels.
In the experimental study, there were no significant differences in the MDA and SOD levels between the groups with different capsulotomy energy levels. An increase in the fragmentation energy from 100% to 150% led to significantly higher MDA levels in the groups with both 90% ( = 0.04) and 150% capsulotomy energy levels ( = 0.03), respectively. However, increased laser spot densities did not result in significant changes in MDA or SOD levels. In the clinical study, all four of the FLACS groups showed higher MDA levels than the conventional group. Similarly, the increase in the fragmentation energy from 100% to 150% resulted in significantly elevated levels of MDA and SOD, respectively.
Although increasing the FSL capsulotomy energy level may not have increased free radicals, higher fragmentation energy levels increased the generation of aqueous free radicals. However, fragmentation with high spot density did not generate additional oxidative stress. Increased spot density did not generate additional oxidative stress, and this can be helpful for dense cataracts.
本研究旨在评估低能量平台飞秒激光辅助白内障手术（FLACS）后不同的囊膜切开和粉碎能量水平对氧化自由基生成的影响。
实验研究包括 60 只猪眼（12 组）。在每组中，分别采用 90%或 150%能量行囊膜切开，90%、100%或 150%能量行粉碎或 150%高能量密度行粉碎。对照组为实验开始时（5 只眼）和结束时（5 只眼）非激光照射的猪眼。在临床研究中，104 只眼分为 5 组，分别行常规超声乳化术（20 只眼）、FLACS 行 90%囊膜切开和 100%粉碎能量水平而不使用非甾体抗炎药（NSAIDs）（16 只眼）、FLACS 行 90%（26 只眼）或 150%（22 只眼）囊膜切开能量水平、100%粉碎能量水平和 NSAIDs、FLACS 行 90%囊膜切开和 150%粉碎能量水平和 NSAIDs（20 只眼）。分析房水样本中的丙二醛（MDA）和超氧化物歧化酶（SOD）水平。
在实验研究中，不同囊膜切开能量水平组间 MDA 和 SOD 水平无显著差异。粉碎能量从 100%增加到 150%，90%（ = 0.04）和 150%（ = 0.03）囊膜切开能量水平组的 MDA 水平显著升高。然而，激光光斑密度增加并未导致 MDA 或 SOD 水平的显著变化。在临床研究中，所有 4 个 FLACS 组的 MDA 水平均高于常规组。同样，粉碎能量从 100%增加到 150%导致 MDA 和 SOD 水平分别显著升高。
虽然增加飞秒激光囊膜切开能量水平可能不会增加自由基，但更高的粉碎能量水平会增加房水自由基的生成。然而，高能量密度粉碎并不会产生额外的氧化应激。增加光斑密度不会产生额外的氧化应激，这对密集白内障有帮助。
