飞秒激光辅助的超声乳化手术对小梁切除术后并发性白内障患者角膜的影响  

Effect of femtosecond laser-assisted cataract phacoemulsification on cornea in complicated cataract patients after trabeculectomy

作　　者：鲍先议[1] 王勇[1] 杨一涛[2] 孙明[1] 彭婷婷[1] BAO Xian-Yi;WANG Yong;YANG Yi-Tao;SUN Ming;PENG Ting-Ting(From the Wuhan Aier Eye Hospital,Wuhan 430063,Hubei Province,China;Heze Municipal Hospital,Heze 274000,Shandong Province,China)

机构地区：[1]武汉爱尔眼科医院,湖北省武汉市430063 [2]菏泽市立医院,山东省菏泽市274000

出　　处：《眼科新进展》2019年第11期1076-1079,共4页Recent Advances in Ophthalmology

基　　金：武汉市卫计委科研基金资助项目(编号:WX15D03);爱尔眼科医院集团科研基金资助项目(编号:AF152D08)~~

摘　　要：目的比较飞秒激光辅助的超声乳化手术和常规超声乳化手术对小梁切除术后并发性白内障患者角膜的影响。方法前瞻性研究。选取我院2017年1月至12月收治的小梁切除术后并发性白内障患者100例100眼,利用随机数字表法将患眼分为两组,分别为行飞秒激光辅助的超声乳化手术的试验组和行常规超声乳化手术的对照组,每组各50例50眼。记录两组患者术前最佳矫正视力(best corrected visual acuity,BCVA)及术后裸眼视力(uncorrected visual acuity,UCVA)。用非接触角膜内皮显微镜(SP-2000P)分别于术前及术后1个月、3个月测量角膜内皮细胞密度(endothelial cell density,ECD);用Pentacam分析仪分别于术前及术后1 d、1个月、3个月测量中央角膜厚度(central corneal thickness,CCT)和角膜体积(corneal volume,CV)。对比两组术中各项超声参数及术后各指标间的差异。结果两组患者核硬度分级、手术时间、灌注液量相比,差异均无统计学意义(均为P>0.05)。两组间超声时间、超声能量、超声累积释放能量之间,差异均有统计学意义(均为P<0.05)。两组术后1 d UCVA相比差异有统计学意义(P=0.025),术前BCVA和术后1个月UCVA两组相比差异均无统计学意义(均为P>0.05)。术前两组患者的ECD、CCT、CV相比,差异均无统计学意义(均为P>0.05)。术后1个月、3个月两组间ECD相比差异均有统计学意义(均为P<0.05),但ECD减少率相比差异均无统计学意义(均为P>0.05)。术后1 d、1个月两组间CCT、CV相比差异均有统计学意义(均为P<0.05),而术后3个月两组间的CCT、CV相比差异均无统计学意义(均为P>0.05)。术后1 d、1个月,两组间CCT、CV增加率相比差异均有统计学意义(均为P<0.05)。术后3个月,两组患者的CCT、CV增加率相比差异均无统计学意义(均为P>0.05)。结论飞秒激光辅助的超声乳化手术能够减轻手术对角膜内皮细胞的损害,缩短角膜水肿恢复时间,降低术后�Objective To investigate the effect of femtosecond laser-assisted phacoemulsification and conventional phacoemulsification on cornea in cataract patients after trabeculectomy.Methods A prospective study was performed in 100 eyes of 100 patients with complicated cataract after trabeculectomy in our hospital from January to December 2017.Using random number table method,the eyes of patients were divided into the experimental group receiving femtosecond laser-assisted phacoemulsification and the control group undergoing conventional phacoemulsification,50 eyes in each group.The best corrected visual acuity(BCVA)before operation and uncorrected visual acuity(UCVA)after operation were recorded in both groups.Corneal endothelial cell density(ECD)was measured by non-contact corneal endothelial microscopy(SP-2000P)before operation and the first month and third month after operation respectively.The central corneal thickness(CCT)and corneal volume(CV)were measured by Pentacam analyzer before operation and the first day,first month and third month after operation respectively,and finally,the differences in the intraoperative ultrasound parameters and the postoperative indexes were compared between the two groups.Results There were no statistical significant differences in nuclear hardness grade,operation time and perfusion volume between the two groups(all P>0.05),while there were significant differences in ultrasound time,ultrasound energy and ultrasound cumulative release energy between the two groups(all P<0.05).There was statistical significant difference in UCVA between the two groups at the first day after operation(P=0.025).There were no statistical significant differences in preoperative BCVA and in UCVA at the first month after operation between the two groups(both P>0.05).There were no statistical significant differences in ECD,CCT and CV between the two groups before operation(all P>0.05).At the first and third month after operation,ECD in the two groups was compared with statistical significant difference(both

关 键 词：飞秒激光 白内障 超声乳化手术 小梁切除手术 角膜内皮细胞密度 中央角膜厚度 角膜体积 

分 类 号：R776.1[医药卫生—眼科]