计算机引导下的飞秒激光辅助白内障手术治疗对患者视力远期预后的影响及其安全性分析

Effects of computer-aided cataract surgery by femtosecond laser on long-term visual prognosis and its safety

目的探讨计算机引导下飞秒激光(femtosecond laser,FSL)辅助白内障手术治疗对患者视力远期预后的影响及其安全性。方法收集2013年1月至6月于我院行手术治疗的白内障患者的临床资料,分为FSL组(45例60眼)和传统组(43例60眼)。FSL组采用计算机引导下FSL辅助白内障手术治疗,传统组采用传统超声乳化白内障手术治疗。统计两组疗效、散光度、眼压,以及治疗前(T0)、治疗后1个月(T_1)、6个月(T_2)、12个月(T_3)和24个月(T_4)的远视力、近视力、裸眼视力、最佳矫正视力及术后并发症发生情况。结果 FSL组总治疗有效率为90.00%,高于传统组76.67%(P<0.05)。两组平均角膜散光度和眼压比较差异均无统计学意义(均为P>0.05);两组术后眼压均低于术前(均为P<0.05)。与T0比较,两组T_1、T_2、T_3、T_4的远视力、近视力、裸眼视力、最佳矫正视力均提高(均为P<0.05);与传统组比较,FSL组T_1、T_2、T_3、T_4的远视力、近视力、裸眼视力、最佳矫正视力均提高(均为P<0.05)。FSL组术后并发症发生率为8.33%,低于传统组的25.00%(P<0.05)。结论计算机引导下FSL辅助手术治疗白内障疗效佳,患者术后近期和远期视力恢复好且并发症发生少,具有良好的可行性和安全性,值得临床推广使用。

Objective To investigate the effects of computer-aided cataract surgery by femtosecond laser（FSL） on long-term visual prognosis and its safety.Methods Eighty-eight cataract patients（120 eyes） underwent surgical treatment in our hospital from January 2013 to June 2013 were randomly divided into FSL group（45 cases,60 eyes） and conventional group（43 cases 60 eyes） by random numbers table.The FSL group adopted computer-aided guided cataract surgery by FSL,while the conventional group adopted traditional phacoemulsification.Curative effect,far visual acuity,near visual acuity,uncorrected near visual acuity and best corrected visual acuity before treatment（T_0） and 1 month（T_1）,6 months（T_2）,12 months（T_3） and 24months（T_4） after treatment,and postoperative complications of two groups were compared.Results Total effective rate of FSL group was 90.00%,which was higher than 76.67% of traditional group（P〈0.05）.The average corneal astigmatism and intraocular pressure of the two groups had no statistical significant difference（P〉0.05）,the postoperative intraocular pressure of the two groups were all lower than the pre-operation（all P〈0.05）.Compared with TO,the far visual acuity,near visual acuity,uncorrected near visual acuity and best corrected visual acuity at T_1,T_2,T_3,T_4 in the two group were improved（all P〈0.05）.Compared with the conventional group,the far visual acuity,near visual acuity,uncorrected near visual acuity and best corrected visual acuity at T_1,T_2,T_3,T_4 in FSL group were improved（all P〈0.05）.Postoperative complications incidence of FSL group was 8.33%,which was less than 25.00% of the conventional group（P〈0.05）.Conclusion Computer-aided cataract surgery by FSL has good curative effect,can improve the immediate and long-term postoperative visual acuity with less complications,which has good feasibility and safety,is worthy of clinical promotion and usage.