飞秒激光辅助白内障手术的临床观察

Clinical observation of femtosecond laser-assisted cataract surgery

目的观察飞秒激光辅助白内障手术的早期临床效果，并与2．2mm同轴微切口白内障超声乳化手术进行比较。方法回顾性病例系列研究。收集2013年12月至2014年5月在连云港市光明医院眼科对白内障核混浊程度为Ⅲ级的白内障患者共102例（120只眼），其中接受飞秒激光辅助白内障手术的患者42例（51只眼），接受2．2mm同轴微切口白内障超声乳化手术的患者60例（69只眼），手术均由同一位医师完成。记录并观察两组术中角膜切口制作的完成情况、囊膜完整性、平均超声能量和有效超声时间，术后1天，1周，1个月观察视力、角膜水肿程度、角膜内皮细胞丢失程度，采用两均数t检验和χ^2检验对数据进行统计学分析。结果飞秒激光辅助白内障手术组累积释放能量和有效超声时间均低于超声乳化白内障手术组，差异有统计学意义（P〈0．05）。飞秒激光辅助白内障手术组角膜内皮细胞数丢失率低于超声乳化白内障手术组，差异有统计学意义（P〈0．05）。术后1天的术前术后OCT测量角膜厚度差值小于超声乳化白内障手术组，差异有统计学意义（P〈0．05），但术后1周，1个月两组的角膜厚度差值差异无统计学意义（P〉0．05）。结论飞秒激光辅助的白内障手术是一种较安全，对眼组织损失更小的手术方式。

Objective To observe the clinical effect of femtosecond laser system in cataract surgery and compared with the 2.2mm coaxial micro incision phacoemulsification cataract surgery. Methods This retrospective case series collected 102 patients （110 eyes） with age-related cataracts that lens opacity was grade Ⅲ from December 2013 to May 2014 in Lianyungang Guang Ming hospital. Forty-two patients （51 eyes） underwent femtosecond laser-assisted cataract surgery, 60 patients （69 eyes） underwent 2.2mm coaxial micro incision phacoemulsification surgery. To The completion of corneal incisions, membrane integrity, mean ultrasound power and effective phaco time in two groups, and the visual acuity, corneal edema and endothelial cell loss were recorded and observed after operation 1 day, 7 days and 1 month. The data were analyzed by t test and χ^2 test. Results The mean ultrasound power and effective phaco time were significantly lower in the femtosecond group than in the phaco group （P 〈0.05）. The endothelial cell loss rate was lower in the femtosecond group than in the phaco group （P 〈0.05）. One day after surgery the difference of the central corneal thickness before and after the operation was smaller in the femtosecond group than in the phaco group （P 〈0.05）, but at 7 days and 1 month after surgery there was no difference between two groups （P 〉0.05）. Conclusions Femtosecond laser-assisted cataract surgery is safe and the damage to the eye tissue is smaller than conventional surgery.