飞秒激光辅助超声乳化手术的效果及预后

Effects of femtosecond laser assisted cataract surgery and the prognosis of patients

目的:分析飞秒激光辅助超声乳化手术(femtosecond laser assisted cataract surgery,FLACS)治疗白内障患者的效果及对其预后的影响。方法:选择2012-01/2014-12我院眼科收治的白内障患者42例42眼作为研究对象,按就诊顺序分为对照组与观察组,各21例21眼,对照组给予传统超声乳化手术(phacoemulsification cataract surgery,PCS)治疗,观察组在此基础上加用飞秒激光治疗,记录两组术中有效超声乳化时间(effective phacoemulsification time,EPT)、超声乳化总能量(cumulative dissipated energy,CDE)、液流量、监测眼压、统计角膜内皮丢失率、房水闪辉情况。两组均随访1a,观察远期视力和并发症情况。结果:观察组总有效率为95%,与对照组的90%对比差异无统计学意义(P>0.05);观察组手术时间长于对照组,差异有统计学意义(P<0.05),但EPT,CDM及液流量均少于对照组,差异有统计学意义(P<0.05);两组术后1d眼压对比差异无统计学意义(P>0.05),观察组房水闪辉、角膜内皮丢失率均低于对照组,差异有统计学意义(P<0.05);术后不同时间两组BCVA均较术前上升,差异有统计学意义(P<0.05),但术后1d,3、6mo,1a观察组BCVA均优于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为14%,低于对照组的43%,差异有统计学意义(P<0.05)。结论:FLACS治疗白内障患者手术效果好、术后视力改善明显、并发症发生率低,但手术时间长、费用高。

AIM： To analyze the effects of femtosecond laser assisted cataract surgery（ FLACS） in the treatm ent of cataract and its effect on prognosis.METHODS： Forty-two cases（ 42 eyes） of patients with cataract who were treated in the Departm ent of Ophthalm ology in our hospital between January 2012 and Decem ber 2014 were selected as the study objects.According to the order of treatm ent,they were divided into control group and observation group,21 cases in each. The control group was treated with traditional phacoem ulsification cataract surgery（ PCS）. On the basis, the observation group was treated with fem tosecond laser. The effective phacoem ulsification tim e（ EPT）,cum ulative dissipated energy（ CDE）,fluid flowand m onitored pressure of the two groups were recorded. The rate of corneal endothelial loss and the situation of Tyndall phenom enon were statistically analyzed. The two groups were followed up for 1a. The long-term visual acuity recovery was observed. The best corrected visual acuity（ BCVA） was recorded,and the long-term com plications were statistically analyzed.RESULTS： 1） The total response rate in observation group was 95% while in control group was 90%（ P〉0. 05）; 2） the surgery tim e of the observation group was longer than that of the control group（ P〈0. 05） but EPT was shorter than that of the control group. CDMand liquid flowwere less than those of the control group（ P〈0. 05）; 3） at 1d after surgery,there was no significant difference in intraocular pressure between the two groups（ P〉0. 05）; the rates of Tyndall phenom enon and corneal endothelial loss in the observation group were lower than those in the control group（ P〈0. 05）; 4） BCVA of the two groups at different tim e after surgery were significantly higher than that before surgery（ P〈0. 05）.However,at 1d,3m o,6m o and 1a after surgery,BCVA of the observation group was better than that of the control group（ P〈0. 05）; 5） the incidence of com plications in the observation group after surgery（ 14%） was lower than that in the control group（ 43%）（ P〈0. 05）.CONCLUSION： The surgical effects of FLACS in the treatm ent of cataract are good. After surgery,the visual acuity of patients is im proved significantly and the incidence of postoperative com plications is low.However,the surgery tim e is long and cost is high,so it is difficult to popularize.