飞秒激光辅助与传统超声乳化术后黄斑和视盘区神经纤维层厚度及血管密度变化

Changes in nerve fiber thickness and vascular density in macula and optic disc after femtosecond laser assisted and conventional phacoemulsification

目的:运用光学相干断层扫描血管成像(OCTA)观察飞秒激光辅助与传统超声乳化白内障术后患者黄斑和视盘区神经纤维层厚度及血管密度变化情况。方法:前瞻性非随机对照研究。纳入2022-07/10于成都东区爱尔眼科医院诊断为年龄相关性白内障患者并住院接受手术治疗的患者65例85眼,根据患者自愿选择手术方式,分为飞秒激光辅助组23例30眼,传统超声乳化组42例55眼。于术前,术后1 d,1 mo均行OCTA检查,比较两组患者黄斑和视盘区神经纤维层厚度、血管密度及血流灌注变化。结果:两组患者术后1 mo BCVA均较术前改善,眼压均较术前降低(均P<0.01);术后1 d,1 mo,飞秒激光辅助组黄斑区神经纤维层厚度较术前增加(均P<0.05),而传统超声乳化组手术前后均无差异(均P>0.05);传统超声乳化组视盘区神经纤维层厚度、黄斑和视盘区血管密度及血流灌注与术前比较均有差异(均P<0.05),而飞秒激光辅助组均无差异(均P>0.05)。两组患者手术前后黄斑中心凹无血管区域(FAZ)面积比较均无差异(均P>0.05)。结论:飞秒激光辅助白内障手术对眼底视网膜血管影响更小。

AIM:To observe the changes of nerve fiber thickness and vessel density in macula and optic disc following femtosecond laser-assisted and conventional phacoemulsification cataract surgery through optical coherence tomography angiography(OCTA).METHODS:A total of 65 cases(85 eyes)that diagnosed with age-related cataract and received surgery in Aier Eye Hospital(East of Chengdu)were included in this prospective nonrandomized controlled study.The patients were divided into two groups according to the surgery choice,with 23 cases(30 eyes)in femtosecond laser assisted group,and 42 cases(55 eyes)in traditional phacoemulsification group.OCTA was used to compare the changes in central macular thickness,thickness of nerve fiber layer in optic disc,vessel density and blood perfusion preoperatively,and at 1 d and 1 mo postoperatively.RESULTS:BCVA of patients in the two groups was significantly improved and IOP was significantly reduced at 1 mo postoperatively(all P<0.01).The macular nerve fiber layer thickness of the femtosecond laser-assisted group was increased at 1 d and 1 mo postoperatively(all P<0.05),while there was no statistical difference in the traditional phacoemulsification group before and after surgery(all P>0.05);there were significant differences in nerve fiber layer thickness in optic disc,vessel density and blood perfusion in both macula and optic disc of the traditional phacoemulsification group(all P<0.05),but there were no differences in the femtosecond laser assisted group(all P>0.05).Furthermore,there were no significant differences in foveal avascular zone area in the two groups of patients(all P>0.05).CONCLUSION:Femtosecond laser-assisted cataract surgery had less impact on retinal vessels.