飞秒激光辅助超声乳化手术与传统超声乳化手术治疗2~3级核白内障的疗效对比

Efficacy comparison of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for grade 2-3 nuclear cataracts

目的观察对比飞秒激光辅助超声乳化手术(FLACS)与传统超声乳化手术治疗2~3级核白内障的疗效及安全性。方法100例(100眼)择期行手术的2~3级核白内障患者,按照自由选择手术治疗方案原则分为观察组与对照组,各50例(50眼)。对照组实施传统超声乳化手术治疗,观察组实施FLACS治疗。比较两组术中参数,术前及术后1、4、12周的裸眼视力和眼压,术前和术后12周的角膜内皮细胞计数与中央角膜厚度,术后并发症发生情况。结果观察组的累积超声乳化能量(4.49±1.39)低于对照组的(7.17±2.05),超声乳化时间(25.65±4.74)s短于对照组的(37.50±4.23)s,差异有统计学意义(P<0.05)。术后1、4、12周,两组的裸眼视力较术前升高,眼压较术前下降,差异有统计学意义(P<0.05);但两组裸眼视力和眼压组间比较,差异无统计学意义(P>0.05)。术后12周,两组角膜内皮细胞计数均较术前减少,中央角膜厚度均较术前增厚,但观察组角膜内皮细胞计数(2440.16±146.67)个/mm^(2)多于对照组的(2363.53±143.56)个/mm^(2),中央角膜厚度(552.67±5.34)μm厚于对照组的(546.52±6.05)μm,差异有统计学意义(P<0.05)。观察组术后并发症发生率8.00%低于对照组的28.00%,差异有统计学意义(P<0.05)。结论白内障患者应用FLACS治疗,可减少术中累积超声乳化能量和超声乳化时间,有效降低患者术后眼压,提高患者术后裸眼视力,保护角膜和角膜内皮组织,安全性较高。

Objective To observe and compare the efficacy and safety of femtosecond laser-assisted cataract surgery(FLACS)and conventional phacoemulsification for grade 2-3 nuclear cataracts.Methods A total of 100 patients(100 eyes)with grade 2-3 nuclear cataracts undergoing elective surgery were divided into an observation group and a control group according to the choice of patients,with 50 patients(50 eyes)in each group.The control group was treated with conventional phacoemulsification,while the observation group was treated with FLACS.Both groups were compared in terms of intraoperative parameters,naked vision and intraocular pressure preoperatively and at postoperative 1,4 and 12 weeks,corneal endothelial cell count and central corneal thickness preoperatively and at 12 weeks postoperatively,and the occurrence of postoperative complications.Results The cumulative phacoemulsification energy(4.49±1.39)in the observation group was lower than(7.17±2.05)in the control group,and the phacoemulsification time(25.65±4.74)s was shorter than(37.50±4.23)s in the control group,and the differences were statistically significant(P<0.05).At postoperative 1,4 and 12 weeks,the naked vision of the two groups was higher than that of this group before surgery,and the intraocular pressure was lower than that of this group before surgery,and the differences were statistically significant(P<0.05).But there was no statistically significant difference in naked vision and intraocular pressure between the two groups(P>0.05).At 12 weeks postoperatively,the corneal endothelial cell count decreased and central corneal thickness thickened in both groups compared with those peroperatively;the corneal endothelial cell count(2440.16±146.67)cells/mm^(2)in the observation group was higher than(2363.53±143.56)cells/mm^(2)in the control group;the corneal central corneal thickness(552.67±5.34)μm in the observation group was thicker than(546.52±6.05)μm in the control group;the differences were statistically significant(P<0.05).The incidence of postoperative complications of the observation group was 8.00%,which was lower than 28.00%of control group,and the difference was statistically significant(P<0.05).Conclusion The application of FLACS for cataract patients can reduce the cumulative phacoemulsification energy and phacoemulsification time,effectively reduce patients'postoperative intraocular pressure,improve patients'postoperative naked vision,and protect the cornea and corneal endothelial tissue with high safety.