飞秒激光辅助超声乳化吸出联合新无级IOL植入术治疗过熟期白内障的效果

The Effectiveness of Femtosecond Laser-assisted Ultrasonic Emulsion Aspiration Combined with New Stepless IOL Implantation in the Treatment of Hypermature Cataract

目的 探讨飞秒激光辅助超声乳化吸出联合新无级IOL植入术治疗过熟期白内障的临床效果。方法 前瞻性临床研究选取2020年1月—2021年5月于大庆油田总医院行白内障超声乳化吸出联合新无级IOL植入术患者50例(100眼),Ⅳ级核,行飞秒激光辅助超声乳化吸出术者25例(50眼),计入观察组;行传统超声乳化吸出术者25例(50眼),计入对照组。术后观察3个月,记录术中累计超声乳化能量释放量(CDE)、有效超声时间(EPT),术后3个月时检测裸眼视力,角膜内皮细胞计数,高阶像差。结果 两组术后裸眼视力较术前均有显著提高,差异有统计学意义(t=51.846、50.848,P<0.05);观察组较对照组术中CDE、EPT均明显减少,差异有统计学意义(t=15.386、23.813,P<0.05);观察组术后角膜内皮细胞数量为(2721.24±261.09)个/mm^(2),多于对照组的(2 526.64±244.38)个/mm^(2),差异有统计学意义(t=3.878,P<0.05);在大瞳孔(5 mm)下,观察组较对照组术后患者高阶像差更小,差异有统计学意义(t=15.291,P<0.05)。结论 飞秒激光辅助超声乳化吸出联合新无级IOL植入术用于治疗过熟期白内障是更安全、有效的方法。

Objective To investigate the clinical application of femtosecond laser-assisted ultrasound emulsion aspiration combined with new stepless IOL implantation for the treatment of hypermature cataract.Methods In the prospective clinical study,50 patients(100 eyes) who received phacoemulsification and new stepless IOL implantation in Daqing Oilfield General Hospital from January 2020 to May 2021,25 patients(50 eyes) who received phacoemulsification and femtosecond laser assisted phacoemulsification were selected as the observation group.Twenty-five cases(50 eyes) underwent traditional phacoemulsification and were included in the control group.The cumulative intraoperative ultrasound emulsion energy release(CDE),effective ultrasound time(EPT),naked eye visual acuity,corneal endothelial cell count,and highorder aberration were recorded at 3 m after surgery.Results Postoperative naked eye visual acuity was significantly improved in both groups compared with preoperative,and the difference was statistically significant(t=51.846,50.848,P<0.05).Intraoperative CDE and EPT were significantly reduced in the observation group compared with the control group,and the difference was statistically significant(t=15.386,23.813,P<0.05).The number of corneal endothelial cells in the observation group was(2 721.24±261.09) cells/mm^(2) after surgery,which was more than(2 526.64±244.38) cells/mm^(2) in the control group,and the difference was statistically significant(t=3.878,P<0.05).At a large pupil(5 mm),the observation group had less higher-order aberration than the control group of patients after surgery,the difference was statistically significant(t=15.291,P<0.05).Conclusion Femtosecond laser-assisted ultrasound emulsion aspiration combined with new stepless IOL implantation is a safer and more effective method for the treatment of overmatched cataract.