飞秒激光辅助与微切口超声乳化白内障摘出术对眼表功能影响的比较  

The effect comparision of femtosecond laser-assisted phacoemusification and microincision phacoemusification on ocular surface

作　　者：许荣 赵少贞[1] Xu Rong;Zhao Shaozhen(Tianjin Medical University Eye Hospital,Tianjin Medical University Eye Institute,College of Optometry and Ophthalmology,Tianjin 300020,China;Xu Rong is working at Hankou Aier Eye Hospital,Wuhan 430000,China)

机构地区：[1]天津医科大学眼科医院,天津医科大学眼视光学院,天津医科大学眼科研究所,300020 [2]武汉爱尔眼科汉口医院,430000

出　　处：《中华实验眼科杂志》2019年第11期907-913,共7页Chinese Journal Of Experimental Ophthalmology

基　　金：武汉市卫生局临床医学科研项目(WX17C33)。

摘　　要：目的比较飞秒激光辅助与微切口超声乳化白内障摘出术对眼表功能的影响。方法采用非随机对照研究设计。连续收集2018年1—3月在武汉爱尔眼科汉口医院就诊的年龄相关性白内障患者116例116眼,根据患者自愿选择的白内障手术方式分为飞秒激光辅助的超声乳化白内障摘出术组(简称飞秒组)55眼和微切口超声乳化白内障摘出术(简称微切口组)61眼。观察2个组术前,术后7 d、30 d眼表疾病指数(OSDI)、泪膜破裂时间(BUT)、角膜荧光素染色评分、基础泪液分泌试验(SⅠt)、结膜杯状细胞密度的变化。结果术后1 d,飞秒组和微切口组最佳矫正远视力(BCDVA)(LogMAR视力)分别为0.14(0.10,0.24)和0.20(0.17,0.27),飞秒组视力较微切口组好,差异有统计学意义(U=-3.140,P=0.002)。与微切口组比较,飞秒组手术时间略长,但超声时间更短,累计能量复合参数(CDE)值更低,平衡盐溶液(BSS)灌注量更少,2个组比较差异均有统计学意义(均P<0.001)。2个组术后7 d、30 d OSDI评分、BUT值、结膜杯状细胞密度均较术前降低,角膜荧光素染色评分均较术前明显升高,差异均有统计学意义(均P<0.05)。2个组手术前后不同时间点SⅠt值波动均较小,组间和不同时间点间总体比较差异均无统计学意义(F分组=0.510,P=0.477;F时间=0.741,P=0.479)。结论与微切口超声乳化白内障摘出术相比,飞秒激光辅助的超声乳化白内障摘出术后早期角膜荧光素染色评分升高、泪膜稳定性下降、结膜杯状细胞密度下降更明显。Objective To compare the effects of femtosecond laser-assisted phacoemusification and microincision phacoemusification on ocular surface.Methods A nonrandomized comparative cohort study was designed.The study recruited 116 eyes of 116 patients with age-related cataract in Hankou Aier Eye Hospital from January to March 2018.Consecutive patients were divided into femtosecond laser-assisted phacoemulsification group(femtosecond laser group for short)(55 eyes)and microincision phacoemulsification group(microincision group for short)(61 eyes).The ocular surface disease index(OSDI),break-up time of tear film(BUT),corneal flurescein staining,SchirmerⅠtest(SⅠt)and goblet cell density were sequentially evaluated preoperatively and postoperatively at 1 week and 1 month.This study followed the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering study cohort.This study protocol was approved by Ethic Committee of Hankou Aier Eye Hospital(No.2017IRB01).Results At 1 day after surgery,the best corrected distance visual acuity(BCDVA)(LogMAR visual acuity)was 0.14(0.10,0.24)and 0.20(0.17,0.27),respectively in the femtosecond laser group and the microincision group.BCDVA in the femtosecond laser group was better than that in the microincision group,with a significant difference between them(U=-3.140,P=0.002).Compared with the microincision group,the operation time was longer,the phaco time was shorter,the cumulative dissipated energy was lower,and the balanced salt solution perfusion volume was less in the femtosecond laser group,with significant differences between them(all at P<0.001).Compared with the pre-operation,the mean OSDI socres,BUT and goblet cell density were significantly decreased,and the fluorescein staining scores were significantly increased at 7 days and 30 days after surgery in the femtosecond laser group and the microincision group,with significant differences between them(all at P<0.05).The SⅠt value fluctuations in the two groups were small at different time

关 键 词：白内障/手术 飞秒激光/治疗应用 干眼 泪膜 显微镜检查/共焦 杯状细胞 前瞻性研究 

分 类 号：R47[医药卫生—护理学]