[关键词]
[摘要]
目的:探讨飞秒激光辅助白内障超声乳化术(FLACS)治疗合并浅前房白内障的临床效果。
方法:前瞻性研究。选取我院2020-11/2021-02收治合并浅前房的白内障患者55例60眼,根据患者意愿选择手术方式并进行分组,接受FLACS的患者为FLACS组,共28例30眼,接受传统白内障超声乳化术(Phaco)的患者为Phaco组,共27例30眼。对患者术前一般情况,术中超声乳化能量释放量(CDE)、有效超声时间(EPT),术后裸眼视力(UCVA)、最佳矫正视力(BCVA)、内皮细胞丢失率(ECL)、黄斑中心凹厚度(CMT)、并发症情况进行比较分析。
结果:两组患者术前一般资料比较无差异(P>0.05)。两组患者术后1d,1wk,1mo的UCVA及术后1wk,1mo的BCVA均优于术前,且FLACS组术后1d UCVA优于Phaco组(P<0.05)。术中CDE、EPT,术后1wk,1mo ECL及术后1d,1wk角膜水肿发生率FLACS组均低于Phaco组(均P<0.05)。两组CMT组内比较及各时期组间比较均无明显差异(P>0.05)。
结论:FLACS治疗浅前房白内障安全、有效,可显著降低术后内皮细胞丢失率、快速恢复视力、减少并发症的发生,且对黄斑无明显影响。
[Key word]
[Abstract]
AIM: To investigate the therapeutic effect of femtosecond laser-assisted cataract surgery(FLACS)in eyes with shallow anterior chamber depth.
METHODS: Totally 60 eyes of 55 cataract patients with shallow anterior chamber who received cataract phacoemulsification in Tangshan eye hospital from November 2020 to February 2021 were selected, and divided into two groups according to the surgical methods on patient's subjective willingness: Patients who received FLACS were assigned to the FLACS group(28 patients, 30 eyes), and patients who received conventional Phaco(27 patients, 30 eyes)were assigned to the Phaco group. Preoperative general conditions, cumulative dissipated energy(CDE), effective phacoemulsification time(EPT), postoperative best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), endothelial cell loss rate(ECL), central macular thickness(CMT)and complications were compared and analyzed.
RESULTS:There was no significant difference in preoperative general data between the two groups(P>0.05). In both groups, UCVA at 1d, 1wk and 1mo after surgery and BCVA at 1wk and 1mo after surgery were better than those before surgery, and at 1d after surgery, UCVA in FLACS group was better than that in Phaco group, the difference was statistically significant(P<0.05). In the FLACS group, CDE, EPT, ECL at 1wk and 1mo after surgery, and the incidence of corneal edema at 1d and 1wk after surgery were all lower than those in the Phaco group(all P<0.05). There was no significant change in CMT in either the intragroup comparison or the intergroup comparison(P>0.05).
CONCLUSION:FLACS is safe and effective in patients with shallow anterior chamber cataract, which can significantly reduce the rate of endothelial cell loss, quickly restore vision, reduce the incidence of complications, and has no significant effect on macula.
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