飞秒激光不同大小晶核碎裂在白内障手术中的临床分析

中国实用眼科杂志 Pub Date : 2017-06-10 DOI:10.3760/CMA.J.ISSN.1006-4443.2017.06.011

Wei Fan

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引用次数: 0

摘要

目的比较飞秒激光白内障手术中不同碎片软化网格对累积耗散能量(CDE)、有效超声乳化时间(EPT)、术中平衡盐溶液体积和角膜内皮细胞损失的影响。方法对2015年6月至2015年11月在厦门市眼科中心接受飞秒激光辅助白内障手术的66例75眼患者进行前瞻性队列研究，随机分为3组:A组:Frag和Chop (350 mm碎片网格和八边形);B组:圆柱体(直径3.0mm);C组:Chop (sestants)。术前采用晶状体混浊分级系统III (LOCS III)对患者进行评估，比较CDE、EPT、平衡盐溶液体积、角膜内皮细胞损失和1个月最佳矫正视力(BCVA)。结果三组患者LOCS III、术前角膜内皮细胞计数比较，差异均无统计学意义(P < 0.05)。与B、C组比较，A组CDE、EPT及术后角膜内皮细胞损失均显著降低(CDE: A组:4.7±2.8,B组:6.4±3.1,C组:6.6±3.0;EPT: A组:23.9±12.s, B组:30.8±11.7s, C组:32.1±12.s;角膜内皮细胞损失:A组:4.2±4.3%，B组:6.7±4.4%，C组:7.2±4.8%;P 0.05)。结论飞秒激光辅助系统在碎裂型白内障手术中应用可显著降低CDE、EPT及术后角膜内皮细胞损失。关键词:飞秒激光;白内障;碎片;CDE;EPT

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Clinical analysis of femtosecond laser fragmentation of the nucleus with different sizes in cataract surgery

Objective To compare the effect of different fragmentation softening grids in femtosecond laser-assisted cataract surgery on cumulative dissipated energy (CDE), effective phacoemulsification time (EPT), balanced salt solution volume during surgery and corneal endothelial cell loss. Methods A prospective cohort study of all patients (66 cases, 75 eyes) who accepted femtosecond laser-assisted cataract surgery in Xiamen ophthalmic center during June 2015 to November 2015 were randomly divided into 3 groups: group A: Frag and Chop (350 mm fragmentation grids and octants); group B: Cylinder (diameter:3.0mm); group C: Chop (sestants). Patients were evaluated preoperatively with the Lens Opacities Classification System III (LOCS III). The CDE, EPT, balanced salt solution volume, corneal endothelial cell loss and best corrected visual acuity (BCVA) at one month were compared. Results There was no statistically significant difference in LOCS III, preoperative corneal endothelial cell count in three groups (P >0.05). Comparing with the group B and C, the CDE, EPT and postoperative corneal endothelial cell loss were significantly lower in group A (CDE: group A: 4.7±2.8, group B: 6.4±3.1, group C: 6.6±3.0; EPT: group A: 23.9±12.0s, group B: 30.8±11.7s, group C: 32.1±12.6s; corneal endothelial cell loss: group A: 4.2±4.3%, group B: 6.7±4.4%, group C: 7.2±4.8%; P 0.05). Conclusions The use of the femtosecond laser-assisted system in cataract surgery with frag and chop led to a statistically significant lower CDE, EPT and postoperative corneal endothelial cell loss. Key words: Femtosecond laser; Cataract; Fragmentation; CDE; EPT

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中国实用眼科杂志

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期刊介绍： China Practical Ophthalmology was founded in May 1983. It is supervised by the National Health Commission of the People's Republic of China, sponsored by the Chinese Medical Association and China Medical University, and publicly distributed at home and abroad. It is a national-level excellent core academic journal of comprehensive ophthalmology and a series of journals of the Chinese Medical Association. China Practical Ophthalmology aims to guide and improve the theoretical level and actual clinical diagnosis and treatment ability of frontline ophthalmologists in my country. It is characterized by close integration with clinical practice, and timely publishes academic articles and scientific research results with high practical value to clinicians, so that readers can understand and use them, improve the theoretical level and diagnosis and treatment ability of ophthalmologists, help and support their innovative development, and is deeply welcomed and loved by ophthalmologists and readers.