飞秒激光辅助超声乳化白内障手术患者的黄斑血流密度和黄斑厚度研究  

Macular blood flow density and macular thickness in femtosecond laser-assisted cataract surgery

作　　者：李康 贺婷婷 郭琼天 司马晶 Li Kang;He Tingting;Guo Qiongtian;Sima Jing(Chongging Bright Eye Hospital,Chongging 400000,China;Jinan University Affiliated Shenzhen Aier Eye Hospital,Shenzhen Guangdong 518000,China)

机构地区：[1]重庆普瑞眼科医院,重庆400000 [2]暨南大学附属深圳爱尔眼科医院,广东深圳518000

出　　处：《眼科》2024年第2期99-104,共6页Ophthalmology in China

基　　金：暨南大学附属深圳爱尔眼科医院科研项目(SZAE2020B02)。

摘　　要：目的利用相干光断层扫描血管成像(OCTA)观察飞秒激光辅助的超声乳化白内障手术患者手术前后黄斑血流密度和黄斑厚度的变化。设计回顾性比较性病例系列。研究对象2020年7月至2021年6月深圳爱尔眼科医院手术治疗的年龄相关性白内障患者,飞秒激光辅助手术者30例(30眼)(飞秒组)和普通超声乳化白内障手术患者30例(30眼)(超乳组)。方法患者于术前,术后1天,1周,1、3个月行0CTA检查,记录黄斑区3mm×3mm(简称3mm区)6mm×6mm(简称6mm区)区域浅层视网膜血流灌注密度、黄斑区3mm区内层及全层视网膜厚度,并进行组间对比。主要指标黄斑区血流密度和黄斑区视网膜厚度。结果黄斑3mm区、6mm区浅层视网膜血流密度:飞秒组术后1天、1周、1个月较术前均减少(P_(3mm)=0.016、0.014、0.011,P_(6mm)=0.042、0.013、0.007)。超乳组术后1天、1周较术前减少(P_(3mm)=0.033、0.040,P<6mm=0.031、0.040)。两组间比较,术后1个月时超乳组3mm区和6mm区浅层视网膜血流密度显著高于飞秒组(t=3.536,P=0.001;t=3.259,P=0.003),其余时间节点两组比较无差异。超乳组黄斑3mm区内层和全层视网膜厚度在术后1、3个月时与术前相比厚度增加(P=0.036、0.031;P=0.019、0.016),且随时间增长呈递增趋势,术后3个月趋于稳定。飞秒组黄斑3mm区内层和全层视网膜厚度在术后1周,1、3个月时较术前增加(P=0.045、0.020、0.005;P=0.038、0.027、0.007),且随时间增长呈递增趋势,术后3个月时趋于稳定。两组间各时间节点比较黄斑3mm区内层和全层视网膜厚度差异均无统计学意义(P均>0.05)。结论飞秒激光辅助白内障手术患者黄斑区浅层视网膜血流密度及视网膜厚度在术后3个月时与传统超声乳化白内障手术患者相比无差异,飞秒激光辅助白内障手术是安全的手术方式。Objective Using optical coherence tomography angiography(OCTA)to observe the changes in macular blood flow density and macular thickness in patients with femtosecond laser cataract surgery.Design Retrospective comparative case series.Par-ticipants From July 2020 to June 2021,60 patients(60 eyes)diagnosed with age-related cataract and treated with surgery in Shenzhen Aier Eye Hospital were selected.30 patients(30 eyes)who underwent femtosecond laser-assisted cataract surgery(femtosecond laser group)and 30 patients(30 eyes)who underwent common phacoemulsification cataract surgery(traditional phacoemulsification group).Methods Patients in each group underwent OCTA examination before surgery,1 day,1 week,1 month,and 3 months after surgery.The superficial retinal blood flow perfusion density in the macular area 3 mm×3 mm(3 mm)and 6 mm×6 mm(6 mm)and the 3 mm macular area of all patients were recorded.Intra-layer and full-layer retinal thickness were measured and compared.Main Outcome Measures Blood flow density and macular thickness.Results Superficial retinal blood flow density in the macular region of 3 mm and 6 mm:fem-tosecond laser group decreased in 1 day,1 week and 1 month after surgery compared with that before surgery(P_(3mm)=0.016,0.014,0.011,P_(6mm)=0.042,0.013,0.007).In traditional phacoemulsification group,the blood flow density decreased in 1 day and 1 week after opera-tion(P_(3mm)=0.033,0.040,P_(6mm)=0.031,0.040).The superficial retinal blood flow density in the 3 mm and 6 mm areas in traditional pha-coemulsification group was significantly higher than that in the femtosecond laser group at 1 month after surgery(t=3.536,P=0.001;t=3.259,P-0.003).Retinal thickness of 3 mm in macular area:the average thickness of inner and whole retinal in traditional phacoemulsification group increased at 1 month and 3 months after surgery compared with the preoperative thickness(P=0.036,0.031;P=0.019,0.016),and showed an increasing trend with time,and tended to be stable at 3 months after surgery.The average thickness of

关 键 词：飞秒激光辅助白内障手术 黄斑区血流密度 相干光断层扫描血管成像 

分 类 号：R779.66[医药卫生—眼科]