飞秒激光辅助屈光性白内障手术效果的初步观察

Preliminary observation of refractive cataract surgery assisted by femtosecond laser

目的:比较飞秒激光辅助屈光性白内障手术与常规屈光性白内障手术术后视力及角膜散光的差异。方法:将老年性白内障合并角膜散光患者60例60眼,按随机自愿原则分为飞秒组及常规组。飞秒组将患者术前角膜散光陡峭轴、平坦轴轴向及屈光度数输入在线矢量计算器,得出相关切口位置、切口宽度后,利用飞秒激光做角膜松解切口、主切口及辅助切口,再按常规行白内障超声乳化+非球面多焦点人工晶状体(multifocal intraocular lenses,IOL)植入术。常规组利用角膜穿刺刀于角膜散光陡峭轴向上做角膜全层松解切口、辅助切口,然后行白内障超声乳化+非球面多焦点IOL植入术。分别于术后1d,1wk,1mo观察两组术眼的角膜散光情况及裸眼远视力(uncorrected distance visual acuity,UCDVA)、裸眼近视力(uncorrected near visual acuity,UCNVA),并进行统计分析。结果:飞秒组和常规组术后裸眼视力均较术前提高,且飞秒组远、近视力均高于常规组;而各时期角膜散光飞秒组均低于常规组。结论:飞秒激光辅助下屈光性白内障手术较传统白内障手术术后角膜散光更小、视力更好,能给患者带来更好的视觉质量。

AIM：To compare the differences of visual acuity and corneal astigmatism postoperatively between conventional refractive cataract surgery and that assisted by femtosecond laser.METHODS：Sixty patients（60 eyes） with age-related cataract and cornea astigmatism were divided into femtosecond group and conventional group randomly or voluntarily.The flat shaft,steep shaft and diopter of corneal astigmatism in patients in femtosecond group were inputted into the online vector calculators to get the location and width of the incision.Then femtosecond laser was used to make corneal releasing incision,the main and auxiliary incision.Phacoemulsification and aspheric multifocal intraocular lens implantation were undergone.Patients in conventional group received full-thickness relaxing incision by cornea paracentesis knife at the steepest meridian axis during phacoemulsification.Then aspheric multifocal intraocular lenses were implanted.Uncorrected distance visual acuity（UCDVA）,uncorrected near visual acuity（UCNVA） and cornea astigmatism were observed at 1d,1wk and 1mo postoperative.RESULTS：UCVA of patients in both groups was improved after the surgeries.UCDVA and UCNVA of femtosecond group were higher than those of conventional group,while the cornea astigmatism of femtosecond group was lower than that of conventional group.CONCLUSION：Refractile cataract surgery assisted by femtosecond laser canoffer better visual quality than conventional refractive cataract surgery because of lower cornea astigmatism and better visual acuity.