Lee Chia-Yi, Yang Shun-Fa, Chen Hung-Chi, Hsueh Yi-Jen, Huang Jing-Yang, Chang Chao-Kai
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.
Nobel Eye Institute, Taipei, Taiwan, R.O.C.
In Vivo. 2025 Sep-Oct;39(5):2728-2738. doi: 10.21873/invivo.14071.
BACKGROUND/AIM: To evaluate alterations in total antioxidant capacity (TAC) and ascorbic acid (AA) levels in femtosecond laser-assisted cataract surgery (FLACS) compared with conventional cataract surgery.
A prospective non-randomized study was conducted wherein 18 and 36 patients undergoing FLACS and conventional cataract surgery, respectively, with the same phacoemulsification and femtosecond laser devices were enrolled. Samples of aqueous humor were obtained via paracentesis before and 1 day after the cataract surgery, and TAC and AA concentrations were determined. The generalized linear mixed model was adopted to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) of changes in TAC and AA between groups.
The TAC and AA levels significantly decreased postoperatively in both groups (=0.05). In the multivariate analysis, the trend in decline in TAC (aOR=0.352, 95% CI=0.218-0.527, =0.0177) and AA (aOR=0.308, 95% CI=0.156-0.488, =0.0204) was significantly lower in the FLACS group. In the subgroup analyses, the correlation between FLACS and smaller TAC reduction was more significant in patients with high myopia, dense cataract, short anterior chamber depth, and greater axial length (<0.05). In addition, the correlation between FLACS and smaller reduction in AA was more significant in patients with high myopia, dense cataract, greater axial length, and greater central corneal thickness (<0.05).
Patients with high myopia and dense cataract may consider FLACS to reduce the possibility of oxidative stress-related postoperative complications.
背景/目的：评估飞秒激光辅助白内障手术（FLACS）与传统白内障手术相比，总抗氧化能力（TAC）和抗坏血酸（AA）水平的变化。
进行了一项前瞻性非随机研究，分别纳入18例接受FLACS和36例接受传统白内障手术的患者，使用相同的超声乳化和飞秒激光设备。在白内障手术前及术后1天通过前房穿刺获取房水样本，测定TAC和AA浓度。采用广义线性混合模型确定两组间TAC和AA变化的调整优势比（aOR）及95%置信区间（CI）。
两组术后TAC和AA水平均显著下降（P<0.05）。在多变量分析中，FLACS组TAC（aOR=0.352，95%CI=0.218-0.527，P=0.0177）和AA（aOR=0.308，95%CI=0.156-0.488，P=0.0204）的下降趋势显著更低。在亚组分析中，高度近视、白内障致密、前房深度短和眼轴长度更长的患者中，FLACS与较小的TAC降低之间的相关性更显著（P<0.05）。此外，高度近视、白内障致密、眼轴长度更长和中央角膜厚度更大的患者中，FLACS与较小的AA降低之间的相关性更显著（P<0.05）。
高度近视和白内障致密的患者可考虑选择FLACS以降低术后氧化应激相关并发症的可能性。
