飞秒激光LenSAR与LenSx联合白内障囊外摘除术在老年白内障患者治疗中的效果比较

目的比较飞秒激光LenSAR与LenSx联合白内障囊外摘除术在老年白内障患者治疗中的效果,以期为临床完善治疗方式提供依据。方法前瞻性选取永煤集团总医院2021年4月至2023年3月期间收治的老年白内障患者96例作为研究对象,依据随机抽签法分成SAR组与Sx组,每组48例。两组均行白内障囊外摘除术,其中SAR组行飞秒激光LenSAR治疗,Sx组行飞秒激光LenSx治疗,统计对比两组围术期指标、手术前后眼压、并发症发生率。结果SAR组前囊膜切开时间、尝试对接次数、预劈核时间以及激光发射时间均少于Sx组,负压吸引眼球时间长于Sx组(P<0.05);术后两组眼压较术前均升高,且SAR组眼压升高幅度高于Sx组(P<0.05);与Sx组27.08%相比,SAR组并发症发生率(8.33%)下降(P<0.05)。结论飞秒激光LenSAR与LenSx联合白内障囊外摘除术在老年白内障患者治疗中的效果各异,其中LenSAR便于接口对接,且并发症少,而LenSx能有效控制眼压且减少总负压吸引眼球时长。

LensAR飞秒激光辅助白内障手术安全性和有效性的临床研究

目的:探讨LensAR飞秒激光辅助白内障手术安全性和有效性的临床效果。方法:在LensAR飞秒激光辅助下,对白内障患者实施手术治疗。结果:术后,患者的CDVA变化优于术前,治疗前、后进行比较,具有统计学意义(P<0.05)。切口位置是影响角膜切口是否可顺利完成的主要影响因素,和边缘呈正相关,眼别和角膜切口与角膜切口是否完成无关联性。结论:LensAR飞秒激光辅助白内障手术,有着较高的安全性和有效性,同时对术者的要求也有所提高,术前,对患者进行健康教育,让其不必担心,良好的心理状态和依从性,利于提高手术成功性。

Accuracy and safety of partial thickness femtosecond laser radial and arcuate keratotomy incisions in porcine eyes

Background:To evaluate the accuracy and safety of micro radial and arcuate keratotomy incisions constructed by a femtosecond laser system with a curved contact patient interface in porcine eyes.Methods:Partial thickness micro radial and arcuate keratotomy incisions were constructed in porcine eyes with a femtosecond laser system and evaluated for precision of depth,quality,and consistency.Optical coherence tomography was used to determine the accuracy and precision of incision depth.Corneal endothelial safety was assessed by a fluorescent live/dead cell viability assay to demonstrate laser-induced endothelial cell loss.Quality was evaluated by ease of opening and examination of interfaces.Results:In two micro radial incision groups,intended incision depths of 50%and 80%resulted in mean achieved depths of 50.01%and 77.69%,respectively.In three arcuate incision groups,intended incision depths of 80%,600μm or 100μm residual uncut bed thickness resulted in mean achieved depths of 80.16%,603.03μm and residual bed of 115μm,respectively.No loss of endothelial cell density occurred when the residual corneal bed was maintained at a minimum of 85-116μm.The incisions were easy to open,and interfaces were smooth.Conclusions:A femtosecond laser system with curved contact interface created precise and reproducible micro radial and arcuate keratotomy incisions.Accuracy and precision of the incision depth and preservation of endothelial cell density demonstrated the effectiveness and safety of the system.

飞秒白内障手术并发症处理及原因分析

目的:回顾性分析飞秒激光辅助超声乳化白内障手术中并发症的发生情况,原因分析及处理,以缩短学习曲线。方法:收集2017年1月～2017年12月在何氏眼科医院进行飞秒激光辅助超声乳化白内障手术的患者42例(58眼),采用LensAR 3D飞秒激光手术系统实行前囊撕开、晶状体预劈核及角膜切口的制作,随后联合超声乳化白内障吸除联合人工晶体植入术。回顾其飞秒激光步骤术中术后并发症情况。结果:术中结膜下出血39眼(67.24%),术中瞳孔缩小4眼(6.90%),前囊机化致前囊撕开不完整1眼(1.72%),激光前PI脱吸2眼(3.44%),切口制作失败6眼(10.34%)。结论:LensAR 3D飞秒激光辅助超声乳化白内障手术是安全、有效、精准的屈光白内障手术方法,在提高患者术后视觉质量、完美体现高端屈光型人工晶体性能方面发挥重要作用。严格挑选合适的患者会降低严重并发症的发生率,获得较高的患者满意度,同时缩短医生学习曲线。