飞秒激光辅助白内障手术联合多焦点人工晶状体植入术的临床应用

Clinical application of femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract

摘要:

目的：探讨飞秒激光辅助白内障手术联合多焦点人工晶状体植入术治疗效果。

方法：选取我院2016-01/2017-01期间入院就诊的白内障患者86例106眼，根据治疗方式不同分为观察组49例59眼，予以飞秒激光辅助超声乳化吸除联合多焦点人工晶状体植入术； 对照组37例47眼，采用传统超声乳化吸除联合多焦点人工晶状体植入术。比较两组患者手术前后角膜内皮细胞密度、术中切口累积消散能量参数(cut cumulative dissipated energy，CDE)、术后视力恢复情况，并观察患者术后并发症。

结果：两组患者术前角膜内皮细胞密度比较差异无统计学意义(P>0.05)，术后1wk两组患者角膜内皮细胞密度均较术前下降，组内比较差异有统计学意义(P<0.05)，对照组较观察组角膜内皮细胞密度低，差异有统计学意义(P<0.05)。术中CDE值观察组均较对照组低，差异有统计学意义(P<0.05)； 术中观察组未发生后囊膜破裂情况，对照组后囊膜破裂发生率为4.3%，差异无统计学意义(P>0.05)。两组患者术后不同时间点最佳矫正视力比较差异具有统计学意义(P<0.01)，观察组术后1、 3mo最佳矫正视力均高于对照组，差异具有统计学意义(P<0.05)。观察组术后出现眩光、光晕现象发生率10.2%，对照组为8.5%，年龄均在60岁以上，差异无统计学意义(P>0.05)。

结论：飞秒激光辅助白内障手术联合多焦点人工晶状体植入术疗效确切、安全性高，但多焦点人工晶状体植入后应考虑眩光、光晕等视觉不良情况。

Abstract:

AIM:To evaluate the effect of femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract.

METHODS: Totally 86 cases(106 eyes)of patients with double cataract in our hospital from January 2016 to January 2017 were selected, including 49 cases(59 eyes)were set as the observation group(treated with femtosecond laser assisted phacoemulsification combined with triple-focus intraocular lens implantation), and 37 cases(47 eyes)were set as the control group(received traditional phacoemulsification combined with triple-focus intraocular lens implantation). Corneal endothelial cell density, cumulative dissipated energy(CDE), distant and near visual accommodation before and after operation were compared between the two groups, postoperative complications were observed.

RESULTS: The preoperative corneal endothelial cell density of two groups had no significant difference(P>0.05). The corneal endothelial cell density of two groups significantly decreased at postoperative 1wk, with statistic significance within groups(P<0.05), and the corneal endothelial cell density of the control group was significantly lower than that of the observation group at postoperative 1wk(P<0.05). The CDE of the observation group were lower than that of the control group, and the difference between the two groups was significant(P<0.05). There were significant differences in best corrected visual acuity at different time points between the two groups(P<0.01). The best corrected visual acuity at 1 and 3mo after operation in the observation group was higher than that in the control group, and the difference was significant(P<0.05). There was no capsular tear in the observation group, while the incidence rate was 4.3% in the control group, with no significant difference between the two groups(P>0.05). The incidence of glare and halo in the observation group was 10.2% and 8.5% in the control group, and are in the patients whose age was above 60 years old, there was no significant difference between the two groups(P>0.05).

CONCLUSION: Femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract can not only improve curative effect, but also provide high safety, while the adverse events including glare, halo and other adverse visual circumstances should be considered after triple-focus intraocular lens implantation.