飞秒激光辅助白内障手术并发症及处理  

Complications and corresponding treatment of femtosecond laser-assisted cataract surgery

作　　者：张广斌[1] 陈伟[1] 毛祖红[1] 叶向彧[1] 王乐[1] 李孟琼[1] 

机构地区：[1]厦门大学附属厦门眼科中心,361001

出　　处：《中国实用眼科杂志》2016年第3期236-240,共5页Chinese Journal of Practical Ophthalmology

基　　金：福建省自然科学基金面上项目（2012D041）;福建省自然科学基金青年创新项目（2012D056）;厦门市科技计划指导性项目（ZD2011S0333）;厦门市科技项目（350220144043）

摘　　要：目的回顾性分析飞秒激光白内障手术中并发症的发生率，了解其学习曲线情况。方法收集2013年6月至2014年5月在厦门大学附属厦门眼科中心进行飞秒激光辅助超声乳化手术的年龄相关性白内障患者225例（260只眼）。采用Aleon LenSx飞秒激光手术系统实行前囊膜圆形截囊，晶状体预劈核和制作角膜切口，随后联合超声乳化白内障摘除人工晶状体植入术，分析手术期间并发症的发生率。并按照手术先后顺序每连续20例患者为一组，考察各组问并发症发生率的差异，了解飞秒激光辅助白内障超声乳化手术的学习曲线。结果176例（67．79％）患者术中发生结膜下出血，18例（6．92％）患者术中出现瞳孔缩小，7例（2．69％）患者前囊截开不完整改为手工完成；3例（1．15％）患者撕囊偏中心；6例（2．31％）患者角膜上皮局部脱落；第一组（前20位患者）的并发症发生率FN1-20与第二组（21-40位患者的发生率）并发症的发生率FN21-40相似，但是与后续其他组间存在明显差异。结论飞秒激光辅助白内障手术学习曲线较短，并发症少，重复性高，安全并有更好的手术体验。Objective To analyze the incidence of complications during femtosecond （FS） la- ser-assisted cataract surgery and get our own learning curve. Methods A total of 225 patients （260 eyes） underwent cataract surgery between June 2013 and May 2014 were enrolled in our research. All patients accepted femtosecond laser-assisted surgery which composed of capsulotomy, lens pre splitting, and corneal incisions using the LenSx platform （Alcon）, and then residual lens were re- moved by Infiniti Vision System （Alcon） and an intraocular lens were implanted. Related complica- tions of femtosecond laser surgery and the treatment were analyzed. Consecutive 20 eyes were divid- ed into an order group, and the incidence of complications in each group was compared to get Chi- nese doctor＇s learning curve. Results One hundred and senvety-six eyes （67.79%） had conjunctiva redness or hemorrhage during the laser procedure, 18 eyes （6.92%） had contractible pupil after laser, 7 eyes （2.69%） had incomplete capsulotomy by laser which were finished by hand. Anterior capsular decentralization occurred in 3 eyes （1.15%） and corneal epithelial damage occurred in 6 eyes during the surgery. No difference was found in the incidence of complications between the first group and secondary group, while significant difference was found when compared the first or second group with other groups. Conclusions Femtosecond laser-assisted cataract surgery had a learning curve dur- ing the first 40 cases. The high safety and repeatability of femtosecond laser-assisted cataract sur- gery were worth aooroving.

关 键 词：飞秒激光 白内障 LenSx 并发症 

分 类 号：R136.9[医药卫生—劳动卫生]