不同年龄患者FLACS术中PI操作时瞳孔直径的变化

Changes of pupil diameter during PI operation in FLACS patients of different ages

目的:探讨不同年龄患者飞秒激光辅助白内障手术(FLACS)中瞳孔直径变化的相关因素及其对患者接口(PI)操作时间和手术疗效的影响。方法:选取2017-03/2018-06在我院行FLACS手术的白内障患者101例101眼,按照年龄分为中青年组(46例)和老年组(55例)。术前常规散瞳,记录PI操作时间、对接时间、劈核半径及PI操作前、中、后的瞳孔直径。术后采用状态焦虑问卷(SAI)评定患者PI操作中的状态焦虑症状,并评估临床疗效。结果:本组患者年龄与PI操作前、中、后瞳孔直径、劈核半径、SAI评分均呈负相关;PI操作时间与SAI评分呈负相关。中青年组患者PI操作前、中、后瞳孔直径(8.89±0.57、7.52±0.52、8.96±0.54mm)均显著大于老年组(8.43±0.73、7.14±0.55、8.44±0.75mm),SAI得分(42.19±9.27分)显著高于老年组(39.80±9.15分)(均P<0.01),但两组患者PI操作时间、对接时间和治疗总有效率均无差异(P>0.05)。结论:FLACS术中中青年患者瞳孔变化较为敏感,且焦虑情绪较为突出,对手术进程有一定影响。

AIM: To investigate the related factors of pupil diameter changes in femtosecond laser-assisted cataract surgery in patients of different ages and their effects on the operation time and surgical efficacy of patient interface. METHODS: One hundred and one patients (101 eyes) with femtosecond laser assisted cataract surgery were enrolled in this study from March 2017 to June 2018, the age group was divided into middle-aged group (46 cases) and old age group (55 cases). Routine mydriasis was carried out in every patient. The operation time of patient interface, docking time, nucleus radius and pupil diameter before, during and after interface operation, best corrected visual acuity before and after surgery were recorded. The state anxiety questionnaire was used to assess the state anxiety symptoms during interfacing operation and evaluate the clinical efficacy. RESULTS: The age of patients with femtosecond laser assisted cataract surgery was significantly negatively correlated with the diameter of the pupil before, during and after the interface operation, the radius of the nucleus, and the state anxiety score. The interface operation time and the state anxiety score were significantly negative correlation. The pupil diameters of the middle-aged patients (8.89±0.57, 7.52±0.52, 8.96±0.54mm) were significantly greater than those of the elderly group (8.43±0.73, 7.14±0.55, 8.44±0.75mm) before, during and after the interface operation,and the state anxiety score (42.19±9.27) was significantly greater than that of the elderly group (39.80±9.15 points)( P <0.01), however there was no difference in interface operation time, docking time and total effective rate of treatment between the two groups ( P >0.05). CONCLUSION: The pupillary changes in middle-aged femtosecond laser-assisted cataract patients are more sensitive and these patients are prone to anxiety, which has certain influence on the progress of the surgery.