飞秒激光联合白内障超声乳化术治疗年龄相关性白内障

Clinical effect of femtosecond laser combined with phacoemulsification in senile cataract patients

目的:探讨飞秒激光联合白内障超声乳化术(PHACO)治疗年龄相关性白内障的临床效果。方法:回顾性分析78例78眼白内障患者的临床资料,行飞秒激光联合PHACO治疗者纳入观察组(40例40眼),单纯行PHACO治疗者纳入对照组(38例38眼)。比较术前和术后1d,1wk,1mo时,两组患者眼压(intraocular pressure,IOP)、最佳矫正视力(best corrected visual acuity,BCVA)[最小分辨角对数视力表(LogMAR)]、中央角膜厚度(central corneal thickness,CCT)、角膜内皮细胞(corneal endothelial cells,CEC)计数、泪液氧化应激指标[前列腺素E_2(PGE_2)、谷胱甘肽过氧化物酶(GSH-Px)]变化。分析两组患者超声乳化时间和术后1mo内并发症发生情况。结果:术后1d,1wk,1mo时,两组患者IOP、BCVA值(LogMAR值)均较术前显著下降,且随术后观察时间延长而呈现明显下降趋势,其中观察组明显低于同期对照组(P<0.05);两组患者CCT、PGE_2水平均较术前显著提升,且随术后观察时间延长而呈现明显下降趋势,其中观察组明显低于同期对照组(P<0.05);两组患者CEC计数、GSH-Px水平均较术前显著下降,且随术后观察时间延长而呈现明显上升趋势,其中观察组明显高于同期对照组(P<0.05)。观察组超声乳化时间及术后1mo内并发症总发生率均明显少于对照组(P<0.05)。结论:飞秒激光联合PHACO可有效改善年龄相关性白内障患者IOP、CCT、CEC计数水平,并降低术后并发症发生风险,对其预后恢复有利。

·AIM:To explore the clinical effect of femtosecond laser combined with cataract phacoemulsification(PHACO)in the treatment of senile patients with cataract.·METHODS:The clinical data of 78(78 eyes)patients with cataract were retrospectively analyzed.Patients with femtosecond laser combined with PHACO were included in observation group(40 cases in 40 eyes),and patients with PHACO alone were included in control group(38 cases in 38 eyes).The changes of intraocular pressure(IOP),best corrected visual acuity(BCVA)[logarithmic visual acuity chart(LogMAR)],central corneal thickness(CCT),corneal endothelial cells(CEC)count and tear oxidative stress indexes[prostaglandin E2(PGE2),glutathione peroxidase(GSH-Px)]were compared before operation,at 1d,1wk and 1mo after operation,and phacoemulsification time and the occurrence of complications within 1mo after operation were analyzed in the two groups.·RESULTS:At 1d,1wk and 1mo after operation,the values of IOP and BCVA in two groups were decreased significantly compared with those before operation,and the values showed significantly decreasing trend with the prolongation of postoperative observation time,and the values in the observation group were significantly lower than those in the control group after treatment(P<0.05).The levels of CCT and PGE2 in two groups were significantly increased compared with those before operation,and the levels showed significantly decreasing trend with the prolonged observation time,and the levels in the observation group were significantly lower than those in the control group(P<0.05).The levels of CEC count and GSH-Px in two groups were significantly decreased compared with those before operation,and the levels showed an obvious upward trend with the prolonged observation time,and the levels in the observation group were significantly higher than those in the control group(P<0.05).The phacoemulsification time and the total incidence rate of complications within 1mo after operation in observation group were significantly lower than those in control group(P<0.05).·CONCLUSION:Femtosecond laser combined with PHACO can effectively improve the levels of IOP,CCT and CEC count in elderly patients with cataract,and reduce the occurrence risk of postoperative complications,and it is beneficial to prognosis and recovery.