飞秒激光白内障手术术源性散光及术后角膜像差的变化研究  

Surgically induced astigmatism and changes in corneal aberrations after femtosecond laser-assisted cataract surgery

作　　者：曾凡超[1,2] 司马晶[1,2] 杨浩江[3] 李敏超[2] 陈炳衡[2] 

机构地区：[1]中南大学爱尔眼科学院,长沙410000 [2]深圳爱尔眼科医院,深圳518031 [3]深圳市第二人民医院,深圳518035

出　　处：《临床眼科杂志》2016年第2期97-100,共4页Journal of Clinical Ophthalmology

基　　金：深圳市科技创新委员会基础研究项目资助(编号:JCYJ201416171850019)

摘　　要：目的分析飞秒激光辅助的白内障超声乳化手术的术源性散光及术后角膜高阶像差的变化。方法分析2014年4月至2015年8月在我院接受白内障手术的50例(60只眼)年龄相关性白内障患者,分为两组:飞秒组27例(30只眼),使用美国Alcon Lenx白内障激光手术系统制作角膜切口、截囊及劈核;超声乳化组23例(30只眼),使用手术刀制作角膜切口、手工连续环形撕囊及劈核。对两组所有术前、术后3个月的术眼使用角膜地形图Pentacam HR测量全角膜散光和角膜6 mm直径范围内的全角膜高阶像差,使用Alpins方法分析全角膜散光,取术源性散光的大小与轴向、矫正率及误差角分析比较。结果飞秒组与超声乳化组术源性散光无明显差异(P>0.05);飞秒组术前与术后3个月全角膜高阶像差各项参数均无明显差异(P均>0.05);而超声乳化组术后3个月全角膜总像差及总高阶像差较术前明显增加(P<0.05)。结论飞秒激光制作角膜切口没有引起全角膜高阶像差的明显改变,飞秒激光制作角膜切口与手工制作角膜切口相比,精准性及术后稳定性更好。Objective To analyze surgically induced astigmatism（ SIA） and changes of postoperative corneal high-order aberration related to femtosecond laser-assisted cataract surgeries（ FLACS）. Methods Authors analyzed clinical data of 50 patients（ 60 eyes） who had cataract surgery during April 2014 to August 2015 in our hospital. Patients were divided into two groups. One group（ Flacs group） of patients（ n = 27; 30 eyes） received femtosecond laser-assisted cataract surgery using Len Sx cataract laser surgery system（ Alcon,United States） for corneal incision,capsulotomy and lens fragmentation. Another 23 patients（ 30 eyes; Phaco group） were treated with keratome created incision,manual continuous curvilinear capsulorhexis,and nuclear fragmentation. Corneal wavefront aberrations（ diameter： 6. 0 mm） and astigmatism were obtained using a Scheimpflug camera（ Pentacam HR） preoperatively and 3 months postoperatively. Alpins method was used to analyze total astigmatism,magnitude and axis deviation of surgically induced astigmatism（ SIA）,correction index（ CI） and angle of error（ AE）. Results There was no significant difference in SIA between the two groups. Corneal aberration indices were not significantly changed after surgery in Flacs group. However,the root mean square of total and higher-order aberrations in Phaco group increased significantly after the surgery（ P〈0. 05）. Conclusions Corneal incisions created by femtosecond laser do not significantly change the high-order aberration of the cornea. Compared with manual methods to create corneal incisions,femtosecond laser resulted in better accuracy and stability.

关 键 词：飞秒激光辅助白内障超声乳化手术 手工角膜切口 全角膜高阶像差 术源性散光 Alpins方法 

分 类 号：R779.66[医药卫生—眼科]