飞秒激光前囊膜切开术与手工连续环形撕囊术对人工晶状体居中性的影响

发布时间：2018-10-07 19:58

【摘要】：目的通过测量并比较飞秒激光前囊膜切开术与连续环形撕囊术术后患者前囊口形态、大小和位置参数,评估其对人工晶状体居中性的影响。方法收集了2015年3月至2016年7月在我院行白内障手术的年龄相关性白内障患者80例(80眼),其中飞秒组40例(40眼),患者行飞秒激光前囊膜切开术;手工组40例(40眼),患者行手工连续环形撕囊术。两组患者年龄、性别构成、眼轴长度和等效球镜度数差异均无统计学意义(均为P0.05),具有可比性。两组术后1周、1个月、1 a复查用数字化裂隙灯照相和Pentacam眼前节分析仪采集眼前节图像,用Image-Pro-Plus 6.0图像分析软件来测量前囊口的水平和垂直直径、圆度、囊膜缘包裹人工晶状体光学部的最大和最小距离、包裹度。运用重复测量方差分析、确切概率法、广义估计方程模型来分析两组间参数差异和人工晶状体居中性预测因子。结果飞秒组和手工组术后1周、1个月,两组间垂直直径、圆度、最大距离、最小距离、包裹度、水平偏移,差异均有统计学意义(均为P0.05);两组间水平直径、垂直偏移,差异均无统计学意义(均为P0.05)。术后1 a,两组间最大距离、最小距离、包裹度、水平偏移,差异均有统计学意义(均为P0.05);两组间垂直和水平直径、圆度、垂直偏移,差异均无统计学意义(均为P0.05)。在飞秒组中,术后1周、1个月、1 a水平偏移均未出现≥0.4 mm者;在手工组中,术后1周、1个月、1 a水平偏移≥0.4 mm眼数和0.4 mm眼数比分别为2/38、4/36、8/32。术后1 a,两组水平偏移≥0.4 mm的分布差异有统计学意义(P0.05)。在单变量广义估计方程模型中,撕囊类型是水平偏移的显著预测因子。而在所有的撕囊参数中,仅包裹度差异有统计学意义(P=0.001)。术后1周、1个月、1 a飞秒组包裹度与水平偏移均存在负相关性(r=-0.89,P0.05;r=-0.72,P0.05;r=-0.58,P0.05);术后1周手工组包裹度与水平偏移亦存在负相关性(r=-0.68,P0.05),而术后1个月、1 a手工组包裹度与水平偏移均无相关性(r=-0.41,P0.05;r=-0.33,P0.05)。结论飞秒激光前囊膜切开术制作的前囊口更圆、更居中,大小更精准,囊袋内人工晶状体位置更稳定,居中性更好。
[Abstract]:Objective to evaluate the effect of femtosecond laser anterior capsule incision on intraocular lens (IOL) by measuring and comparing the shape, size and location of anterior capsule orifice after femtosecond laser anterior capsule incision and continuous circular capsulorhexis. Methods from March 2015 to July 2016, 80 patients (80 eyes) with age-related cataract underwent cataract surgery in our hospital. 40 patients (40 eyes) in femtosecond group were treated with femtosecond laser anterior capsulorotomy. 40 cases (40 eyes) of manual group were treated with continuous circular capsulorhexis. There were no significant differences in age, sex composition, axial length and equivalent spherical degree between the two groups (P0.05). The anterior segment images were collected by digital slit lamp photography and Pentacam anterior segment analyzer 1 week, 1 month and 1 year after operation. The horizontal and vertical diameter and roundness of anterior capsule orifice were measured by Image-Pro-Plus 6.0 image analysis software. The maximum and minimum distance and degree of encapsulation of the optical part of the intraocular lens wrapped by the capsule rim. Repeated measurement variance analysis, exact probability method and generalized estimation equation model were used to analyze the difference of parameters between the two groups and the population neutral predictor of intraocular lens (IOL). Results there were significant differences in vertical diameter, roundness, maximum distance, minimum distance, wrapping degree and horizontal deviation between femtosecond group and manual group 1 week and 1 month after operation (P0.05). The difference was not statistically significant (P0.05). After 1 year, the maximum distance, minimum distance, wrapping degree, horizontal deviation between the two groups were statistically significant (P0.05); the vertical and horizontal diameter, roundness, vertical deviation between the two groups were not statistically significant (P0.05). In femtosecond group, 1 month or 1 month after operation, no horizontal deviation 鈮，

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