糖尿病并发白内障患者飞秒激光辅助与传统超声乳化白内障摘出术后晶状体前囊膜的变化比较  

Comparison of lens anterior capsular changes between femtosecond laser-assisted phacoemulsification and conventional phacoemulsification for cataract patients with diabetes

作　　者：曾宗圣 张广斌 Zeng Zongsheng;Zhang Guangbin(Xiamen Eye Center Affiliated to Xiamen University,Xiamen 361001,China)

机构地区：[1]厦门大学附属厦门眼科中心,361001

出　　处：《中华实验眼科杂志》2019年第10期793-798,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：福建省自然科学基金青年创新项目(2013D017).

摘　　要：目的比较飞秒激光辅助超声乳化白内障摘出手术与传统超声乳化白内障摘出手术后糖尿病并发白内障患者前囊膜混浊(ACO)及前囊口大小的变化.方法采用非随机对照研究设计.纳入2015年3月至2016年8月于厦门大学附属厦门眼科中心拟行白内障摘出手术的糖尿病并发白内障患者85例85眼,按照手术方法不同分为飞秒激光辅助白内障超声乳化白内障摘出术组(简称飞秒激光组)43例43眼和传统超声乳化白内障摘出术组(简称传统手术组)42例42眼.飞秒激光组术中采用AlconLenSx平台完成5.3mm环形截囊,传统手术组术中在AlconVERION设备引导下完成5.3mm连续居中环形撕囊.采用ACO临床分级评估ACO程度;采用ImageProPlus6软件对术毕显微镜下拍摄的图片及术后裂隙灯显微镜后照法所获取的图片前囊口面积进行测量.分别于术后1、3和6个月计算不同级别ACO的眼数分布,并比较2个组前囊口面积.结果术毕时2个组术眼晶状体前囊口面积比较差异无统计学意义(t=0.003,P=0.958).术后1、3和6个月2个组前囊口面积总体比较差异有统计学意义(F组别=73.602,P<0.001;F时间=378.895,P<0.001),各时间点传统手术组前囊口面积均小于飞秒激光组,差异均有统计学意义(均P<0.001).术后1个月飞秒激光组和传统手术组前囊膜Ⅰ级混浊比例分别为67.4%(29/43)和61.9%(26/42),组间比较差异无统计学意义(P=0.133);术后3个月飞秒激光组前囊膜Ⅱ级混浊比例分别为11.6%(5/43),明显低于传统手术组的66.7%(28/42),组间比较差异有统计学意义(P<0.001);术后6个月飞秒激光组前囊膜Ⅲ级混浊比例为14.0%(6/85),明显低于传统手术组的73.8%(31/43),组间比较差异有统计学意义(P<0.001).结论糖尿病并发白内障患者选择飞秒激光辅助超声乳化白内障摘出术可降低ACO发生风险,减轻前囊口收缩程度.Objective To compare the anterior capsule opacification and contraction of lens following femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract patients with diabetes. Methods A non-randomized control study was carried out.Eighty-five eyes of 85 cataract patients with diabetes were included from March 2015 to August 2016 in Xiamen Eye Center.The patients were divided into 2 groups based on the different surgeries.Forty-three eyes of 43 patients in the femtosecond laser group received femtosecond laser-assisted phacoemulsification and completed the 5.3 mm capsulorhexis using the Alcon LenSx femtosecond laser platform.Forty-two eyes of 42 patients in the conventional surgery group underwent conventional phacoemulsification group and performed 5.3 mm continuous circular capsulorhexis under the guidance of Alcon VERION.Anterior capsule opacification (ACO) was graded according to Werner's method.The area of anterior capsular opening was calculated by using Image Pro Plus 6 software.The number of eyes in different grades of ACO and anterior capsule opening area between two groups were compared at 1 month, 3 months and 6 months after operation. Results Initial anterior capsular opening area was not significantly different between the femtosecond laser group and the conventional phacoemulsification group (t=0.003, P=0.958). The anterior capsule opening area in the two groups among different time-points after operations was significantly different (Fgroup=73.602, P<0.001;Ftime=378.895, P<0.001), and anterior capsule opening areas were smaller in the conventional phacoemulsification group than those in the femtosecond laser group at various time points after operation (all at P<0.001). At 1 month after suigery, grade Ⅰ of the ACO was found in 29 eyes (67.4%) in the femtosecond laser group and 26 eyes (61.9%) in the conventional phacoemulsification group, and there was no significant difference between two groups (P=0.133). At 3 months after surgery, the incidence rate of grade �

关 键 词：白内障/手术 糖尿病 激光/治疗用途 飞秒激光辅助超声乳化白内障摘出术 晶状体前囊膜 

分 类 号：R779.6[医药卫生—眼科] R587.2[医药卫生—临床医学]