玻璃体切除术后白内障行无玻璃体腔灌注飞秒激光辅助超声乳化术的效果

The efficacy of femtosecond laser assisted phacoemulsification without vitreous cavity perfusion in cataract after vitrectomy

目的评估玻璃体切除术后白内障患者无玻璃体腔灌注下行飞秒激光辅助超声乳化手术的临床效果。方法回顾性病例对照研究。纳入苏州大学附属理想眼科医院2019年1月至2021年7月玻璃体切除术后白内障55例(55眼)。将患者按白内障手术方式分为两组:A组27例行飞秒激光辅助超声乳化术;B组28例行传统超声乳化术。所有患者术中均未放置玻璃体腔灌注,均植入单焦点人工晶状体。术后随访3个月比较两组视力、术中超声乳化时间及释放能量、角膜内皮细胞密度(CED)、眼压。结果术中超声乳化时间及释放能量:A组低于B组;术后随访A组视力优于B组,CED高于B组(均P<0.05);两组间眼压差异无统计学意义(P>0.05)。结论无玻璃体腔灌注下飞秒激光辅助超声乳化手术治疗玻璃体切除术后白内障较传统超声乳化手术术后视力更好、角膜内皮损伤更小。

Objective To evaluate the clinical efficacy of femtosecond laser assisted phacoemulsification in the treatment of cataract after vitrectomy without vitreous cavity perfusion.Methods This was a retrospective case control study.From Jan.2019 to Jul.2021,total of 55 eyes of 55 patients with cataract after vitrectomy in Lixiang Eye Hospital Affiliated to Soochow University were included.They were divided into two groups based on cataract surgical methods:27 cases in group A underwent femtosecond laser assisted phacoemulsification and 28 cases in group B underwent traditional phacoemulsification.There were no vitreous cavity perfusion placed during phacoemulsification.The monofocal intraocular lens were implanted to all patients.All patients were followed up for 3 months.The visual acuity,intraoperative phacoemulsification time,cumulative released energy,corneal endothelial cell density(CED)and intraocular pressure were compared between the two groups.Results Intraoperative phacoemulsification time and cumulative released energy of group A were significantly lower than those of group B.The vision and CED of group A were better than those of group B(all P>0.05).There was no significant difference in intraocular pressure between the two groups(P>0.05).Conclusion Phacoemulsification without vitreous cavity perfusion for the treatment of cataract after vitrectomy obtains good effect.Compared with traditional phacoemulsification,femtosecond laser assisted phacoemulsification achieves better vision and less corneal endothelial cell loss.