飞秒激光辅助超声乳化白内障吸除术角膜切口的形态学改变
|
摘要
目的:观察飞秒激光辅助超声乳化白内障吸除术(2.4mm微切口)及传统超声乳化白内障吸除术(2.4mm微切口)角膜切口的形态学的改变,评估两者切口的稳定性。方法:本研究为前瞻性对照研究。患者89例99眼接受白内障手术,根据术式分为两组:飞秒激光组:飞秒激光超声乳化手术组44例49眼;角膜刀组:2.4mm白内障超声乳化手术组45例50眼。术后应用OCTA评估角膜切口形态改变。结果:术后1d飞秒激光组未发现外切口哆开,角膜刀组发生率为10%(P<0.05);术后1wk,1、3mo两组均未见外切口哆开。术后1wk,1mo飞秒激光组内切口哆开的发生率分别为47%、10%,均低于角膜刀组(术后1wk为68%,1mo为26%)(P<0.05),术后1d,3mo两组无差异。两组各时间点局部后弹力层脱离的发生率均无差异。结论:飞秒激光辅助超声乳化白内障吸除术角膜切口早期愈合更好,有效减少早期角膜切口异常构筑的发生。
?AIM: To observe the morphology of corneal incision between femtosecond laser-assisted cataract surgery(FLACS) with 2.4 mm micro-incision and conventional phacoemulsification cataract surgery(CPCS) with 2.4 mm micro-incision, evaluating the safety and stability of the incision.?METHODS: This was a prospective controlled study. A total of 89 cataract patients(99 eyes) who underwent cataract surgery were collected. All patients were divided into two groups: 44 cases(49 eyes) in FLACS group and 45 cases(50 eyes) in CPCS group. Morphology of clear corneal incision was observed by OCTA postoperative.?RESULTS: There was no external wound dehiscence in FLACS group on 1 d postoperative, while 10% patients had external wound dehiscence in CPCS group(P<0.05). There were no external wound dehiscence in both groups on 1 wk, 1 mo and 3 mo postoperative. On 1 wk and 1 mo postoperative, the incidences of internal wound dehiscence in FLACS group(47% of 1 wk and 10% of 1 mo) were lower than that in CPCS group. There were statistically significant difference(68% of 1 wk and 26% of 1 mo)(P<0.05). On 1 d and 3 mo postoperative, there were no significant difference in internal wound dehiscence in both groups. There were no significant differences in descemet membrane detachment(DMD) in both groups.?CONCLUSION: Femtosecond laser-assisted cataract surgery(FLACS) is benefit for wound closure and reducing abnormal incision construction.
?AIM: To observe the morphology of corneal incision between femtosecond laser-assisted cataract surgery(FLACS) with 2.4 mm micro-incision and conventional phacoemulsification cataract surgery(CPCS) with 2.4 mm micro-incision, evaluating the safety and stability of the incision.?METHODS: This was a prospective controlled study. A total of 89 cataract patients(99 eyes) who underwent cataract surgery were collected. All patients were divided into two groups: 44 cases(49 eyes) in FLACS group and 45 cases(50 eyes) in CPCS group. Morphology of clear corneal incision was observed by OCTA postoperative.?RESULTS: There was no external wound dehiscence in FLACS group on 1 d postoperative, while 10% patients had external wound dehiscence in CPCS group(P<0.05). There were no external wound dehiscence in both groups on 1 wk, 1 mo and 3 mo postoperative. On 1 wk and 1 mo postoperative, the incidences of internal wound dehiscence in FLACS group(47% of 1 wk and 10% of 1 mo) were lower than that in CPCS group. There were statistically significant difference(68% of 1 wk and 26% of 1 mo)(P<0.05). On 1 d and 3 mo postoperative, there were no significant difference in internal wound dehiscence in both groups. There were no significant differences in descemet membrane detachment(DMD) in both groups.?CONCLUSION: Femtosecond laser-assisted cataract surgery(FLACS) is benefit for wound closure and reducing abnormal incision construction.
引文
1中华医学会眼科学分会.我国白内障术后急性细菌性眼内炎治疗专家共识(2010年).中华眼科杂志2010;46(8):764-766
2 Kashiwabuchi FK,Khan YA,Jr RM,et al.Seidel and India ink tests assessment of different clear cornea side-port incision configurations.Graefes Arch Clin Exper Ophthalmol 2013;251(8):1961-1965
3 Can I,Takmaz T,Yildiz Y,et al.Coaxial,microcoaxial,and biaxial microincision cataract surgery:prospective comparative study.J Cataract Refract Surg 2010;36(5):740
4刘奕志.应当客观评价飞秒激光在白内障摘除手术中的应用.中华眼科杂志2016;52(2):81-84
5 Ashley B,Stark WJ,Pratzer KA,et al.Dynamics of small-incision clear cornea wounds after phacoemulsification surgery using optical coherence tomography in the early postoperative period.J Refract Surg 2008;24(1):46
6姜英梅,韩峰,金日.白内障超声乳化术不同切口与发生急性眼内炎的关系分析.医学综述2012;18(11):1761-1762
7彭希,刘谊.应用AS-OCT研究白内障超声乳化吸除术后角膜结构的改变.四川大学学报(医学版)2013;44(1):147-150
8张玲.不同角度2.8mm透明角膜切口构型的动态变化及安全性评估.中华实验眼科杂志2017;10(35):924
9 Conradhengerer I,Hengerer FH,Schultz T,et al.Effect of femtosecond laser fragmentation on effective phacoemulsification time in cataract surgery.J Refract Surg 2012;28(12):879
10田芳,苏龙,孙靖,等.飞秒激光在白内障手术中的应用进展.中华眼科杂志2013;49(6):574-576
11 Popovic M,Campos-M?ller X,Schlenker MB,et al.Efficacy and Safety of Femtosecond Laser-Assisted Cataract Surgery Compared with Manual Cataract Surgery:A Meta-Analysis of 14567 Eyes.Ophthalmology 2016;123(10):2113
12王勇,鲍先议,周龑丽,等.飞秒激光辅助超声乳化白内障吸除术的初步评估.中华眼科杂志 2015;51(9):689-693
2 Kashiwabuchi FK,Khan YA,Jr RM,et al.Seidel and India ink tests assessment of different clear cornea side-port incision configurations.Graefes Arch Clin Exper Ophthalmol 2013;251(8):1961-1965
3 Can I,Takmaz T,Yildiz Y,et al.Coaxial,microcoaxial,and biaxial microincision cataract surgery:prospective comparative study.J Cataract Refract Surg 2010;36(5):740
4刘奕志.应当客观评价飞秒激光在白内障摘除手术中的应用.中华眼科杂志2016;52(2):81-84
5 Ashley B,Stark WJ,Pratzer KA,et al.Dynamics of small-incision clear cornea wounds after phacoemulsification surgery using optical coherence tomography in the early postoperative period.J Refract Surg 2008;24(1):46
6姜英梅,韩峰,金日.白内障超声乳化术不同切口与发生急性眼内炎的关系分析.医学综述2012;18(11):1761-1762
7彭希,刘谊.应用AS-OCT研究白内障超声乳化吸除术后角膜结构的改变.四川大学学报(医学版)2013;44(1):147-150
8张玲.不同角度2.8mm透明角膜切口构型的动态变化及安全性评估.中华实验眼科杂志2017;10(35):924
9 Conradhengerer I,Hengerer FH,Schultz T,et al.Effect of femtosecond laser fragmentation on effective phacoemulsification time in cataract surgery.J Refract Surg 2012;28(12):879
10田芳,苏龙,孙靖,等.飞秒激光在白内障手术中的应用进展.中华眼科杂志2013;49(6):574-576
11 Popovic M,Campos-M?ller X,Schlenker MB,et al.Efficacy and Safety of Femtosecond Laser-Assisted Cataract Surgery Compared with Manual Cataract Surgery:A Meta-Analysis of 14567 Eyes.Ophthalmology 2016;123(10):2113
12王勇,鲍先议,周龑丽,等.飞秒激光辅助超声乳化白内障吸除术的初步评估.中华眼科杂志 2015;51(9):689-693