飞秒激光辅助白内障手术与传统超声乳化白内障手术对眼高阶相差影响的对比研究

Comparison of femtosecond laser-assisted cataract surgery versus traditional phacoemulsification cataract surgery for high-order aberrations

目的研究飞秒激光辅助白内障手术与传统超声乳化白内障手术对眼高阶相差的影响。方法白内障患者随机分为飞秒激光组和超声乳化组。其中,飞秒激光组60例(60只眼),男性28例(28只眼),女性32例(32只眼);超声乳化组53例(53只眼),男性20例(20只眼),女性33例(33只眼)。所有患眼术前及术后3个月检查眼高阶像差。结果 4 mm瞳孔直径下组内比较:两组患眼全眼和眼内的高阶相差各项指标均较术前减少,差异有统计学意义;角膜的高阶像差较术前增加,差异无统计学意义。6 mm瞳孔直径下组内比较:两组患眼全眼和眼内的高阶相差各项指标均较术前减少,差异有统计学意义;角膜的高阶像差较术前增加,除角膜的彗差(Coma)及次级散光(2ndAstig)指标变化无统计学意义外,余变化均有统计学意义。4 mm瞳孔直径下组间比较:飞秒激光组与超声乳化组全眼、角膜及眼内各项高阶像差两组间变化比较均无统计学意义。6 mm瞳孔直径下组间比较:飞秒激光组较超声乳化组矫正全眼及眼内高阶像差更显著,全眼及眼内各项高阶像差两组间变化比较均有统计学意义(除眼内2ndAstig外)。但角膜的各项高阶像差变化组间差异不明显,差异均无统计学意义。结论飞秒激光辅助白内障手术和传统超声乳化白内障手术均能有效减少全眼及眼内高阶相差,从6 mm瞳孔直径下观察,飞秒激光组较超声乳化组矫正全眼及眼内高阶像差更显著,但对角膜的各项高阶像差改变,两组差异不明显。

Objective To observe the effects of femtosecond laser-assisted cataract surgery versus traditional phacoemulsification cataract surgery on high-order aberrations. Methods Cataract patients were randomly divided into observation group（60 eyes） and control group（ 53 eyes）. The control group was treated by traditional ultrasonic emulsification operation. Observation group was treated with femtosecond laser technology. High-order aberrations were compared for all eyes before and 3 months after surgery. Results The overall and intraocular high-order aberration at 4 mm pupil size significantly decreased in both group of patients. Corneal high-order aberration insignificantly increased. There was no difference between the groups. Changes at 6 mm pupil size was same-overall and intraocular aberrations decreased significantly,but corneal aberrations increased significantly except coma and 2 nd astigmatism. Improvement in overall and intraocular aberration was significantly more predominant in patients treated with femtosecond laser-assisted cataract surgery（ except 2 nd astigmatism）,but there was no difference between the 2 groups in corneal aberrations. Conclusions Femtosecond laser assisted cataract surgery and traditional phacoemulsification cataract surgery can effectively reduce whole eye and intraocular high-order aberrations. This effect is more predominant when measured at 6 mm pupil size. But there was no difference in corneal aberrations between the two treatments.