飞秒激光辅助白内障超声乳化手术治疗软核白内障的临床疗效及对角膜内皮的影响

Clinical effect of femtosecond laser assisted phacoemulsification for soft-nucleus cataract and its influence on corneal endothelium

目的探讨飞秒激光辅助白内障超声乳化手术治疗软核白内障的临床疗效及对角膜内皮的影响。方法96例软核白内障患者,按照计算机编号的单双数分为对照组和观察组,各48例。对照组采用传统白内障超声乳化手术治疗,观察组采用飞秒激光辅助白内障超声乳化手术治疗。比较两组患者手术指标相关参数;手术前与手术后1、3个月的视力情况;手术前与手术后3个月的角膜内皮功能与形态。结果观察组有效超声时间(6.02±1.89)s、手术时间(58.32±10.24)min均短于对照组的(7.97±2.14)s、(70.63±11.80)min,平均超声能量(6.39±1.75)%低于对照组的(10.05±1.94)%,术后1个月的眼压(IOP)为(13.78±1.46)mm Hg(1 mm Hg=0.133 kPa)低于对照组的(14.54±2.03)mm Hg,Ⅱ级核累积超声能量(CDE)值(6.44±1.48)、Ⅲ级核CDE值(17.49±3.05)均低于对照组的(8.63±1.73)、(22.76±3.18),差异均具有统计学意义(P<0.05)。观察组患者术后1个月的裸眼视力(0.16±0.04)、最佳矫正视力(0.16±0.04)均优于对照组的(0.28±0.08)、(0.23±0.06),差异均具有统计学意义(P<0.05)。术后3个月,观察组患者角膜内皮细胞计数(2265.84±378.56)个/mm2、中央角膜厚度(565.42±7.74)μm、角膜内皮细胞变异系数(28.78±4.29)均优于对照组的(2020.36±384.16)个/mm2、(577.65±8.10)μm、(32.35±5.02),差异均具有统计学意义(P<0.05)。结论采用飞秒激光辅助白内障超声乳化手术治疗软核白内障,可明显提高手术效率,改善角膜内皮功能形态,减轻视力障碍。

Objective To discuss the clinical efficacy of femtosecond laser assisted phacoemulsification for soft-nucleus cataract and its influence on corneal endothelium.Methods A total of 96 patients with soft-nucleus cataract were divided into control group and observation group according to computer number,with 48 cases in each group.The control group was treated with traditional phacoemulsification,and the observation group was treated with femtosecond laser assisted phacoemulsification.The surgical related parameters,visual acuity before operation and 1,3 months after the operation,corneal endothelial function and morphology before operation and 3 months after operation were compared between the two groups.Results The effective ultrasound time(6.02±1.89)s and operation time(58.32±10.24)min of the observation group were shorter than(7.97±2.14)s and(70.63±11.80)min of the control group,mean ultrasonic energy(6.39±1.75)%was lower than(10.05±1.94)%of the control group,the intraocular pressure(IOP)1 month after operation(13.78±1.46)mm Hg(1 mm Hg=0.133 kPa)was lower than(14.54±2.03)mm Hg of the control group,and gradeⅡnuclear cumulative dissipated energy(CDE)(6.44±1.48)and gradeⅢCDE(17.49±3.05)were lower than(8.63±1.73)and(22.76±3.18)of the control group.All the difference was statistically significant(P<0.05).1 month after operation,the naked vision(0.16±0.04)and best corrected vision(0.16±0.04)of the observation group were better than(0.28±0.08)and(0.23±0.06)of the control group,and the difference was statistically significant(P<0.05).3 months after operation,the corneal endothelial cell count(2265.84±378.56)/mm2,central corneal thickness(565.42±7.74)μm and coefficient of variation of corneal endothelial cells(28.78±4.29)of the observation group were better than(2020.36±384.16)/mm2,(577.65±8.10)μm and(32.35±5.02)of the control group,and the difference was statistically significant(P<0.05).Conclusion Femtosecond laser assisted phacoemulsification for soft-nucleus cataract can significantly improve the operation efficiency,improve the corneal endothelial function and morphology,and reduce visual impairment.