飞秒激光辅助白内障手术联合多焦点人工晶状体植入术对患者视功能的影响

Impact of Femtosecond Laser Assisted Cataract Surgery Plus Multifocal Intraocular Lens Implantation on Visual Functions

目的探讨飞秒激光辅助白内障手术联合多焦点人工晶状体(intraocular lens,IOL)植入治疗对患者视觉质量的影响。方法 2018年3月至2019年3月,双眼白内障患者70例140只眼,采用数字随机法分成两组,对照组35例70只眼,行超声乳化白内障联合多焦点IOL植入治疗;观察组患者35例70只眼,采用飞秒激光辅助白内障手术联合多焦点IOL植入治疗。术后3个月比较两组患者手术前后角膜散光度、眼压变化、裸眼远视力及最佳矫正视力改善情况,观察两组患者治疗总有效率和并发症情况。结果术后3个月,观察组总有效率(91. 4%)略高于对照组(85. 7%)(P>0. 05);观察组术后角膜散光度略高于对照组,差异具有统计学意义(P<0. 05);两组患者裸眼视力、最佳矫正视力均明显改善,观察组裸眼视力、最佳矫正视力改善优于对照组(P<0. 05);术中观察组累积乳化能量(cumulative dissipated energy, CDE)、有效乳化时间(effective phaco time,EPT)均低于对照组(P<0. 05);观察组并发症发生率为14. 3%,对照组为28. 6%,差异具有统计学意义(P<0. 05)。结论飞秒激光辅助白内障手术联合多焦点IOL植入可更好的改善患者裸眼视力和最佳矫正视力,缓解手术创伤导致角膜散光度变化,减少术中超声能量积累缩短超声乳化时间,提升治疗效果和安全性。

Objective To investigate the impact of femtosecond laser assisted cataract surgery plus multifocal intraocular lens(IOL) implantation on visual quality of patients.Methods Totally 70 patients of binocular cataract treated from Mar.2018 to Mar.2019 were selected and randomly divided into two groups,namely the control group and observation group,each consisting of 35 patients(70 eyes).The patients in the control group were given phacoemulsification plus multifocal IOL implantation,and those in the observation group femtosecond laser-assisted cataract surgery plus multifocal IOL implantation.The corneal astigmatism,intraocular pressure changes,far-field far vision and best corrected visual acuity were compared respectively 3 months after operation in two groups.The total effective rates and complications of the group were also compared Results Three months after operaion,the total effective rate of the observation group was 91.4%,which was slightly higher than85.7% of the control group(P>0.05).Compared with the control group,the corneal astigmatism of the observation group did not fluctuated greatly,and the difference was statistically significant(P<0.05).The visual acuity and best corrected visual acuity in both groups were significantly improved.The improvement of near vision and best corrected visual acuity in the observation group was greater than that in the control group(P<0.05).The cumulative dissipated energy(CDE) and effective phaco time(EPT) of the observation group were better than that of the control group(P<0.05).The complication rate was 14.3% in the observation group and28.6% in the control group.The difference was statistically significant(P<0.05).Conclusions Femtosecond laser-assisted cataract surgery plus multifocal IOL implantation will bring in greater improvement of the naked eye vision and best corrected visual acuity of the patients,relieve the corneal astigmatism caused by surgical trauma,reduce the intraoperative ultrasound energy accumulation,shorten the phacoemulsification time and improve the therapeutic effect and safety.