飞秒激光辅助白内障超声乳化术中患者眼球旋转的临床观察

Clinical observation of cyclotorsion during femtosecond laser-assisted cataract surgery

目的探讨飞秒激光辅助白内障超声乳化术(FLACS)中眼球旋转的规律。方法前瞻性分析2018年1月至2021年1月行FLACS的患者679例(775眼)的临床资料。术前应用VERION数字导航系统在坐位时采集术眼眼前节图像,术中应用配有VERION数字导航系统的Alcon LenSx飞秒激光手术设备获取患者仰卧位时眼前节图像,记录术中眼球旋转的方向和角度。结果775眼中,719眼(92.77%)发生了旋转,内旋最多见。患者逆时针旋转度数(5.08°±3.49°)大于顺时针旋转度数(4.29°±2.85°),差异有统计学意义(P=0.001)。患者内旋度数(5.12°±3.38°)大于外旋度数(3.86°±2.67°),差异有统计学意义(P<0.001)。患者右眼与左眼相比,顺时针及逆时针旋转发生率、旋转度数、顺时针旋转度数、逆时针旋转度数、内旋度数差异均有统计学意义(均为P<0.05)。男性患者外旋度数(4.58°±3.14°)大于女性患者(3.37°±2.18°),差异有统计学意义(P=0.001)。年龄<50岁患者和年龄≥50岁患者相比,眼球旋转方向和旋转度数差异均无统计学意义(均为P>0.05)。结论FLACS手术中,眼球普遍存在一定程度的旋转,眼球旋转的规律主要与眼别有关。VERION数字导航系统的应用可以使飞秒激光角膜切开术更加精确。

Objective To investigate the rules of cyclotorsion in femtosecond laser-assisted cataract surgery(FLACS).Methods The clinical data of 679 patients(775 eyes)who underwent FLACS from January 2018 to January 2021 were prospectively analyzed.Before operation,VERION digital navigation system was used to collect the anterior segment image of the operating eye in sitting position.During operation,Alcon LenSx femtosecond laser surgical equipment equipped with VERION digital navigation system was used to obtain the anterior segment image in supine position,and the direction and angle of cyclotorsion during operation were recorded.Results During the FLACS,cyclotorsion occurred in 719 eyes(92.77%),and incyclotorsion was the most common.The degree of counterclockwise rotation(5.08°±3.49°)was greater than that of clockwise rotation(4.29°±2.85°),and the difference was statistically significant(P=0.001).The degree of incyclotorsion(5.12°±3.38°)was greater than that of excyclotorsion(3.86°±2.67°),and the difference was statistically significant(P<0.001).There were significant differences in clockwise and counterclockwise rotation rate,rotation angle,clockwise rotation angle,counterclockwise rotation angle and incyclotorsion angle between the right eye and the left eye(all P<0.05).The male excyclotorsion(4.58°±3.14°)was greater than female excyclotorsion(3.37°±2.18°)with significant difference(P=0.001).There was no significant difference in the direction and angle of cyclotorsion between patients aged<50 years and patients aged≥50 years(both P>0.05).Conclusion In FLACS,eye cyclotorsion generally exists to a certain extent,and the rules of cyclotorsion are mainly related to eye type.The application of VERION navigation can make femtosecond laser keratotomy more accurate.