飞秒激光辅助白内障术后初期截囊性状分析及影响因素研究  

Analysis of characteristics and influencing factors of capsulotomy in the early stage after femtosecond laser assisted-cataract surgery

作　　者：赵振波 马立威 韩冬 唐凯莉 丁雨溪 张劲松 王静 ZHAO Zhenbo;MA Liwei;HAN Dong;TANG Kaili;DING Yuxi;ZHANG Jinsong;WANG Jing(Department of Ophthalmology,Aier Excellent Eye Hospital,Shenyang 110000,China;Aier Institute of Cataract and Intraocular Lens,Shenyang 110000,China;Aier Eye Hospital Affiliated to Anhui Medical University,Hefei 230031,China)

机构地区：[1]沈阳爱尔卓越眼科医院眼科,沈阳110000 [2]爱尔眼科白内障与人工晶状体研究所,沈阳110000 [3]安徽医科大学附属爱尔眼科医院眼科,合肥230031

出　　处：《中国眼耳鼻喉科杂志》2024年第3期196-201,共6页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：2021年爱尔眼科集团科研基金项目自由探索计划(AF2102D6);2021年沈阳市中青年科技创新人才支持计划项目(RC210388)。

摘　　要：目的对飞秒激光辅助白内障术后初期截囊口性状进行分析,并探讨其影响因素。方法前瞻性观察性研究。选取2022年1—8月在沈阳爱尔卓越眼科医院诊断为单纯年龄相关性白内障并行飞秒激光辅助白内障手术的患者45例(51眼)作为研究对象。记录飞秒激光程序的设定截囊直径(PCD),收集术后第1天囊口形态数据,包括实际截囊直径(AACD)、截囊口圆度、截囊口面积、人工晶状体(IOL)包裹面积等,探讨年龄、不同襻设计IOL、眼轴(AL)、角膜曲率(Km)、中央角膜厚度(CCT)、前房深度(ACD)、晶状体厚度(LT)对截囊直径偏差(DDC)的影响。结果术后第1天囊口形态:AACD为(5.46±0.25)mm,圆度为0.990(0.988,0.993);截囊口面积为23.16(21.92,24.83)mm2;IOL包裹面积为5.10(3.43,6.34)mm^(2)。飞秒激光PCD为(5.34±0.12)mm,术后1天AACD为(5.46±0.25)mm,DDC为0.11 mm(0.06~0.17 mm),PCD与术后1天AACD差异有统计学意义(P<0.001)。采用逐步线性回归分析法探讨DDC与各因素相关性。纳入DDC与年龄、不同襻设计IOL、Km、CCT、ACD、LT、AL进行多元线性回归。得出年龄(b=-0.01,t=-5.63,P<0.001)和不同襻设计IOL(b=0.18,t=4.12,P<0.001)对DDC有影响,差异有统计学意义。构建回归公式:DDC=0.81-0.01×年龄,R^(2)=0.3945。结论眼部参数不会对飞秒激光截囊形态有明显影响,DDC与年龄、不同襻设计IOL有相关性,针对不同年龄、不同襻设计IOL可以更细化调整个性化的PCD。Objective To analyze the characteristics of capsulotomy after femtosecond laser-assisted cataract surgery and to explore its influencing factors.Methods A prospective observational study.Femtosecond laser assisted-cataract surgeries were performed in 51 eyes with age-related cataract alone from January 2022 to August 2022,at Shenyang Aier Excellent Eye Hospital.The programmed capsulotomy diameters(PCD)were recorded,and the data of capsulotomy were collected on the first day after surgery:including actual achieved capsulotomy diameter(AACD),circular,area,the parcel area of intraocular lens(IOL)and so on.The effects of age,different loop design IOLs,axis of the eye(AL),corneal curvature(Km),central corneal thickness(CCT),anterior chamber depth(ACD)and lens thickness(LT)on capsular diameter were investigated.Results On the first postoperative day,AACD was 5.46±0.25mm;capsulotomy circular was 0.990(0.988,0.993)and capsulotomy area was 23.16(21.92,24.83)mm^(2).The parcel area of IOL was 5.10(3.43,6.34)mm2.Femtosecond laser PCD was 5.34±0.12 mm,and AACD was 5.46±0.25 mm,the deviation of the diameter of capsulotomy(DDC)was 0.11 mm(0.06-0.17),the difference was small but statistically significant(P<0.001).Stepwise linear regression analysis was used to investigate the correlation between DDC and various factors.It was concluded that the age(b=-0.01,t=-5.63,P<0.001)and different loop design IOL(b=0.18,t=4.12,P<0.001)had significant effect on the DDC.The regression formula was established:DDC=0.81-0.01×age,R^(2)=0.3945.Conclusions The eye parameters have no significant effect on the shape of capsulotomy.DDC is correlated with age and different loop design IOLs.The capsular diameter can be personalized according to age and IOL loop morphology.

关 键 词：飞秒激光辅助白内障手术 人工晶状体 截囊 

分 类 号：R7[医药卫生—临床医学]