[1]袁媛,彭华琮,陈雅琼.飞秒激光辅助白内障手术与传统白内障手术联合Toric人工晶状体植入术治疗长眼轴白内障患者的临床疗效比较[J].眼科新进展,2020,40(2):144-147.[doi:10.13389/j.cnki.rao.2020.0034]
 YUAN Yuan,PENG Huacong,CHEN Yaqiong.Comparative analysis of clinical efficacy between femtosecond laser-assisted cataract surgery and traditional cataract surgery combined with Toric IOL implantation in treatment of long-axis cataract[J].Recent Advances in Ophthalmology,2020,40(2):144-147.[doi:10.13389/j.cnki.rao.2020.0034]
点击复制

飞秒激光辅助白内障手术与传统白内障手术联合Toric人工晶状体植入术治疗长眼轴白内障患者的临床疗效比较/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年2期
页码:
144-147
栏目:
应用研究
出版日期:
2020-02-05

文章信息/Info

Title:
Comparative analysis of clinical efficacy between femtosecond laser-assisted cataract surgery and traditional cataract surgery combined with Toric IOL implantation in treatment of long-axis cataract
作者:
袁媛彭华琮陈雅琼
430019 湖北省武汉市,武汉艾格眼科医院
Author(s):
YUAN YuanPENG HuacongCHEN Yaqiong
Department of Ophthalmology,Wuhan Eyegood Ophthalmic Hospital,Wuhan 430019,Hubei Province,China
关键词:
飞秒激光白内障Toric人工晶状体视觉质量
Keywords:
femtosecond lasercataractToric IOLvisual quality
分类号:
R779
DOI:
10.13389/j.cnki.rao.2020.0034
文献标志码:
A
摘要:
目的 比较飞秒激光辅助白内障手术与传统白内障手术联合Toric人工晶状体植入术治疗长眼轴白内障患者的临床疗效。方法 选取在我院行白内障手术眼轴长度大于24 mm的白内障患者49例49眼,按患者主观意愿选择术式;飞秒组患者20例20眼,均行飞秒激光辅助白内障手术;传统组患者29例29眼,均行传统白内障手术。两组患者术中眼内均植入 Toric人工晶状体。每例患眼均行IOL-Master、OPD-SCAN Ⅲ视觉质量分析仪检测,获得患者散光度、最佳矫正视力(best corrected visual acuity,BCVA)、角膜规则指数、表面不对称指数、不规则散光指数、角膜球差及像差与斯特列尔比值。角膜规则指数、表面不对称指数、不规则散光指数、角膜球差及眼高阶像差与斯特列尔比值相关情况采用Spearman相关分析。结果 术后3个月,两组患者BCVA均较术前显著提高,差异均有统计学意义(均为P<0.05);飞秒组患者BCVA为0.09±0.09,传统组为0.13±0.10,两组相比差异无统计学意义(P>0.05)。术前飞秒组患者散光度为(1.84±0.57)D,传统组为(2.17±0.83)D,两组比较差异无统计学意义(P>0.05)。术后3个月,飞秒组患者总残余散光度为(0.50±0.50)D,传统组为(0.55±0.37)D,两组间比较差异无统计学意义(P>0.05)。术后3个月,飞秒组患者斯特列尔比值为0.18±0.15,传统组为0.15±0.12,两组比较差异无统计学意义(P>0.05)。术后3个月,飞秒组患者斯特列尔比值与角膜规则指数、表面不对称指数、不规则散光指数、角膜球差之间均无相关性(均为P>0.05);传统组亦均无相关性(均为P>0.05)。飞秒组患者斯特列尔比值与全眼人工晶状体倾斜棱镜、3-8阶所有项高阶像差总和、高阶球面像差呈负相关(均为P<0.05)。传统组患者斯特列尔比值与角膜0-8阶所有项高阶像差总和、人工晶状体倾斜棱镜,眼内人工晶状体倾斜棱镜、3-8阶所有项高阶像差总和、高阶彗差、高阶球面像差,全眼人工晶状体倾斜棱镜、3-8阶所有项高阶像差总和、高阶彗差、高阶球面像差均呈负相关(均为P<0.05)。结论 飞秒激光辅助白内障手术与传统白内障手术联合Toric人工晶状体植入术均能显著提高长眼轴白内障患者术后视力。
Abstract:
Objective To compare the clinical effects between femtosecond laser-assisted cataract surgery and traditional cataract surgery combined with Toric intraocular lens (IOL) implantation in treatment of patients with long-axis cataract.Methods Totally 49 eyes of 49 cataract patients with axial length longer than 24 mm received cataract surgery in our hospital were selected,and divided into two groups according to the surgical methods on patient’s subjective willingness:Femtosecond group (20 eyes in 20 patients) received femtosecond laser-assisted cataract surgery;traditional group (29 eyes in 29 patients) received traditional cataract surgery.All patients received Toric IOL implantation during surgery.IOL-Master and OPD-SCAN III visual quality analyzer were used for examination of affected eyes,to collect astigmatism,best corrected visual acuity (BCVA;converted to logMAR),corneal regularity index,surface asymmetry index,irregular astigmatism index,corneal spherical aberration and higher-order aberration and Strehl ratio.Spearman correlation analysis was used to analyze the relation of corneal regularity index,surface asymmetry index,irregular astigmatism index,corneal spherical aberration and higher-order aberration with Strehl ratio.Results Three months after surgery,BCVA was higher than that before surgery in both two groups (both P<0.05).BCVA were 0.09±0.09 in femtosecond group and 0.13±0.10 in traditional group,and no significant difference was observed between the two groups (P>0.05).Before surgery,the astigmatism were (1.84±0.57)D in femtosecond group and (2.17±0.83)D in traditional group,and there was no significant difference between the two groups (P>0.05).Three months after surgery,the total residual astigmatism were (0.50±0.50)D in femtosecond group and (0.55±0.37)D in traditional group,and there was no significant difference between the two groups (P>0.05).Three months after surgery,the Strehl ratios were 0.18±0.15 in femtosecond group and 0.15±0.12 in traditional group,and there was no significant difference between the two groups (P>0.05).Three months after surgery,there was no correlation of Strehl ratio with corneal regularity index,surface asymmetry index,irregular astigmatism index or corneal spherical aberration in the femtosecond group (all P>0.05) or in the traditional group (all P>0.05).Strehl ratio had negative correlation with the full ocular artificial lens oblique prism,total high-order aberrations at 3-8 orders and high-order spherical aberration in femtosecond group (all P<0.05).For patients in traditional group,Strehl ratio had negative correlation with total high-order aberrations at 3-8 orders,artificial lens oblique prism,IOL oblique prism,high-order coma,high-order spherical aberration (all P<0.05).Conclusion Femtosecond laser-assisted cataract surgery and traditional cataract surgery combined with Toric IOL implantation can significantly improve postoperative visual acuity in patients with long-axis cataract.

参考文献/References:

[1] DAVID F A,MUKESH D,CHRISTINE B,MICHAEL S K.Global prevalence and economic and humanistic burden of astigmatism in cataract patients:a systematic literature review[J].Clin Ophthalmol,2018,6(12):439-452.
[2] 肖迟,何海燕,刘园珍,钟伟友,杨玉芳.两种散光矫正型人工晶状体术后效果及中长期旋转稳定性观察及比较[J].中国医药科学,2018,8(6):225-227.

XIAO C,HE H Y,LIU Y Z,ZHONG W Y,YANG Y F.Observation and comparison of postoperative effects and mid- and long-term rotational stability of two kinds of astigmatism-corrected intraocular lenses[J].Chin Med Pharm,2018,8(6):225-227.
[3] 冯宇宁.Toric人工晶状体矫正老年性白内障合并角膜散光的临床疗效分析[J].中国实用医药,2018,13(7):66-67.

FENG Y N.Toric intraocular lens correction of senile cataract with corneal astigmatism[J].Chin Pract Med,2018,13(7):66-67.
[4] 王晓明,汤欣,郑秀华.VERION数字导航系统行散光矫正型人工晶状体(Toric IOL)轴位标记与传统裂隙灯标记方法的对比研究[J].眼科新进展,2018,38(2):153-155.

WANG X M,TANG X,ZHENG X H.Comparative study of VERION digital navigation system astigmatism correction intraocular lens(Toric IOL) axial position marking and traditional slit lamp marking method[J].Rec Adv Ophthalmol,2018,38(2):153-155.
[5] 王旭.结合散光矫正型人工晶状体治疗合并角膜散光白内障的临床疗效[J].世界最新医学信息文摘,2018,18(10):63-64.

WANG X.Clinical efficacy of astigmatic correction of intraocular lens in the treatment of corneal astigmatism with astigmatism[J].World Latest Med Inform,2018,18(10):63-64.
[6] 段练.现代白内障手术方式与人工晶状体选择对术后视觉质量的影响[D].济南:山东大学,2017:63-64.

DUAN L.The effect of modern cataract surgery and intraocular lens selection on postoperative visual quality[D].Jinan:Shandong University,2017:63-64.
[7] NINOMIYA Y,MINAMI K,MIYATA K,EGUCHI S,SATO R,OKAMOTO F,et al.Toric intraocular lenses in eyes with with-the-rule,against-the-rule,and oblique astigmatism:One-year results[J].J Cataract Refract Surg,2016,42(10):1431-1440.
[8] EMESZ M,DEXL A K,KRALL E M,BACHERNEGG A,MOUSSA S,JELL G,et al.Randomized controlled clinical trial to evaluate different intraocular lenses for the surgical compensation of low to moderate-to-high regular corneal astigmatism during cataract surgery[J].J Cataract Refract Surg,2015,41(12):2683-2694.
[9] VESEL M,BARKOV D,BUJALKOV D,GARAJOV D.The effect of multifocal toric lens rotation on visual quality[J].Cesk Slov Oftalmol,2016,72(2):3-11.
[10] CHEN X,ZHAO M,SHI Y,YANG L,LU Y,HUANG Z.Visual outcomes and optical quality after implantation of a diffractive multifocal toric intraocular lens[J].Indian J Ophthalmol,2016,64:285-291.
[11] BALESTRAZZI A,BAIOCCHI S,BALESTRAZZI A,CARTOCCI G,TOSI G M,MARTONE G,et al.Mini-incision cataract surgery and toric lens implantation for the reduction of highmyopic astigmatism in patients with pellucid marginal degeneration[J].Eye (Lond),2015,29(5):637-642.
[12] 孟克青.散光矫正型人工晶状体治疗合并角膜散光白内障的临床疗效评价[J].中国卫生标准管理,2017,8(4):40-42.

MENG K Q.Evaluation of clinical efficacy of astigmatism corrected intraocular lens in the treatment of corneal astigmatism with astigmatism[J].Chin Heal Stand Manag,2017,8(4):40-42.
[13] 周沐瑶,窦晓燕,杨浩江,李林,郭疆.非球面散光型人工晶状体治疗白内障合并规则角膜散光的临床分析[J].深圳中西医结合杂志,2016,26(18):17-20.

ZHOU M Y,DOU X Y,YANG H J,LI L,GUO J.Clinical analysis of aspheric astigmatic intraocular lens for the treatment of cataract with regular corneal astigmatism[J].Shenzhen J Int Tradit Chin West Med,2016,26(18):17-20.

相似文献/References:

[1]乔建治 张永喜.抗青光眼术后白内障行不同切口超声乳化术的临床疗效分析[J].眼科新进展,2012,32(4):000.
[2]吴星.年龄相关性白内障患者超声乳化手术前后对比敏感度分析[J].眼科新进展,2012,32(6):000.
[3]王勇 叶应嘉 鲍先议 周龑丽 许荣 彭婷婷 曾志富.同轴微小切口超声乳化吸出术在青光眼滤过术后白内障摘出术中的应用[J].眼科新进展,2012,32(7):000.
[4]徐威.注射器针头囊袋内吸附劈核法在白内障手术中的应用[J].眼科新进展,2012,32(7):000.
[5]冉文瑛 陈静 张树利.抗青光眼术后不同角膜切口白内障超声乳化术对角膜屈光状态的影响[J].眼科新进展,2012,32(7):000.
[6]王运.常规连续模式超声乳化术与爆破模式冷超声乳化术治疗白内障的临床疗效比较[J].眼科新进展,2012,32(11):000.
[7]李福生 尹鸿芝 周跃华.飞秒激光制瓣负压吸引对视网膜神经纤维层厚度和神经节细胞复合体厚度的影响[J].眼科新进展,2013,33(1):000.
[8]郭照洪 王宏 宋爱平 文译 侯祺 解柳.超声乳化白内障摘出联合人工晶状体植入治疗超高度轴性近视白内障患者的临床疗效[J].眼科新进展,2013,33(1):000.
[9]董坤峰 张印博 张继玲 尹会苏 康焕君 申华.飞秒激光制瓣再次LASIK治疗LASIK术后近视的临床疗效观察[J].眼科新进展,2013,33(1):000.
[10]刘珣 王欣玲 柏全豪 张劲松 阎启昌.IOLMaster与四种人工晶状体屈光度计算公式的准确性研究[J].眼科新进展,2013,33(2):000.
[11]方兴,兰长骏,廖萱.飞秒激光在白内障手术中的应用[J].眼科新进展,2016,36(2):197.[doi:10.13389/j.cnki.rao.2016.0054]
 FANG Xing,LAN Chang-Jun,LIAO Xuan.Application of femtosecond laser in cataract surgery[J].Recent Advances in Ophthalmology,2016,36(2):197.[doi:10.13389/j.cnki.rao.2016.0054]
[12]张笑天,东莉洁,田芳,等.非甾体类药物预防飞秒激光辅助白内障术中瞳孔缩小的观察与分析[J].眼科新进展,2016,36(5):457.[doi:10.13389/j.cnki.rao.2016.0122]
 ZHANG Xiao-Tian,DONG Li-Jie,TIAN Fang,et al.Observation and analysis of nonsteroidal drugs in preventing intraoperative miosis of femtosecond assist cataract surgery[J].Recent Advances in Ophthalmology,2016,36(2):457.[doi:10.13389/j.cnki.rao.2016.0122]
[13]王静,赵江月,陆璐,等.液体浸润式飞秒激光平台辅助的白内障手术初步研究[J].眼科新进展,2018,38(1):044.[doi:10.13389/j.cnki.rao.2018.0009]
 WANG Jing,ZHAO Jiang-Yue,LU Lu,et al.Preliminary clinical research on liquid-immersion femtosecond laser assisted cataract surgery[J].Recent Advances in Ophthalmology,2018,38(2):044.[doi:10.13389/j.cnki.rao.2018.0009]
[14]周?莉,张红.飞秒激光辅助的白内障手术对2型糖尿病患者术中房水细胞因子表达的影响[J].眼科新进展,2018,38(8):786.[doi:10.13389/j.cnki.rao.2018.0186]
 ZHOU Yan-Li,ZHANG Hong.Effects of femtosecond laser assisted cataract surgery on the expression of aqueous cytokine in patients with type 2 diabetes mellitus[J].Recent Advances in Ophthalmology,2018,38(2):786.[doi:10.13389/j.cnki.rao.2018.0186]
[15]鲍先议,王勇,杨一涛,等.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[J].眼科新进展,2019,39(11):1076.[doi:10.13389/j.cnki.rao.2019.0247]
 BAO Xian-Yi,WANG Yong,YANG Yi-Tao,et al.Effect of femtosecond laser-assisted cataract phacoemulsification on cornea in complicated cataract patients after trabeculectomy[J].Recent Advances in Ophthalmology,2019,39(2):1076.[doi:10.13389/j.cnki.rao.2019.0247]
[16]陈威,周婧,杜君,等.飞秒激光弧形角膜切开术对白内障合并角膜散光患者的矫正效果[J].眼科新进展,2019,39(12):1137.[doi:10.13389/j.cnki.rao.2019.0261]
 CHEN Wei,ZHOU Jing,DU Jun,et al.The effect of femtosecond-assisted arcuate keratotomy on cataract patients with corneal astigmatism[J].Recent Advances in Ophthalmology,2019,39(2):1137.[doi:10.13389/j.cnki.rao.2019.0261]
[17]孙智勇,颜华.飞秒激光在白内障手术中的应用进展[J].眼科新进展,2021,41(1):094.[doi:10.13389/j.cnki.rao.2021.0020]
 SUN Zhiyong,YAN Hua.Application of femtosecond laser in cataract surgery[J].Recent Advances in Ophthalmology,2021,41(2):094.[doi:10.13389/j.cnki.rao.2021.0020]
[18]张敏,季敏,吴坚,等.飞秒激光辅助白内障超声乳化术中患者眼球旋转的临床观察[J].眼科新进展,2021,41(10):956.[doi:10.13389/j.cnki.rao.2021.0201]
 ZHANG Min,JI Min,WU Jian,et al.Clinical observation of cyclotorsion during femtosecond laser-assisted cataract surgery[J].Recent Advances in Ophthalmology,2021,41(2):956.[doi:10.13389/j.cnki.rao.2021.0201]

备注/Memo

备注/Memo:
武汉市卫计委科研计划资助青年项目(编号:WX18Q29)
更新日期/Last Update: 2020-02-05