iTrace 评估飞秒激光辅助白内障超声乳化手术术后视觉质量的临床观察

目的 比较飞秒激光辅助白内障超声乳化手术与传统超声乳化手术后自然状态下高阶像差、调制传递函数值(modulation transfer function,MTF)的变化,为白内障患者术前手术方式方案选择以及提高白内障患者术后视觉质量提供指导。方法 对2016年7月至2017年7月在山东潍坊眼科医院就诊行白内障超声乳化吸除联合人工晶状体(IOL)植入术,随机选取且随访资料完整白内障患者82例100眼,按手术方式分组:实验组为飞秒激光辅助白内障超声乳化手术组45例52眼,对照组为传统超声乳化手术组37例48眼。术后1天、1周、1月分别测量2组患者的最佳矫正视力(BCVA),使用iTrace视功能分析仪测量两组术眼自然状态下取瞳孔直径为3 mm的高阶像差(总眼高阶像差、球差、彗差、三叶草像差)及总高阶像差下的MTF。数据采用单因素方差分析。结果 2组的BCVA在术后1天、1周有差异,有统计学意义,术后1月的BCVA无明显差异,不具统计学意义;术后1天、1周、1月实验组术眼自然状态下取得瞳孔直径为3 mm全眼的总高阶像差、慧差、球差、三叶草像差优于对照组,具有统计学意义,高阶像差下MTF优于对照组,具有统计学意义;术后1天、1周、1月实验组术眼全眼总高阶像差均值低于对照组,两组都随时间变化呈递减趋势,且两者均值随时间变化逐渐接近。术后1天、1周、1月实验组术眼总高阶像差下的MTF均值高于对照组,两组都随时间变化呈递增趋势,且两者均值随时间变化逐渐接近。结论 飞秒激光辅助白内障手术与传统超声乳化白内障手术相比具有更好的视觉质量。飞秒激光辅助白内障手术术后早期能获得更好的视觉质量。

Clinic effects on comparison of femtosecond laser-assisted cataract surgery and conventionalphacoemulsification in patients with cataract

Objective To study the visual quality of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in patients with cataract.Methods In this case-control study,a total of 83 patients were randomly divided into study group (52 eyes) and control group (48 eyes).Postoperative 1 day,1 week,1 month measured 2 groups of patients the best corrected visual acuity (BCVA),iTrace visual function analyzer is used to measure the two naturally take group a high order aberration of the pupil diameter is 3 mm (total eye High order aberration,Spherical,coma,trefoil) and total higher-order aberration of the modulation transfer function (MTF).Data using the single factor analysis of variance.Results Two groups of BCVA 1 d after surgery,there were differences in postoperative 1 week, there was statistical significance,no obvious difference was found between postoperative BCVA of 1 month, no statistical significance.After 1 day,1 week,1 month experimental eyes naturally made full eye pupil diameter of 3 mm total eye High order aberration,Spherical,coma,trefoil was better than that of control group,with statistical significance,high-order aberration of MTF was better than that of control group,with statistical significance.After 1 day,1 week,1 month, all experimental surgery eye the mean total higher-order aberrations was lower than the control group,both groups showed a trend of decline over time,and both the mean gradually close to change over time.Postoperative 1 day,1 week,1 month experimental technique under the eye always higher-order aberrations of MTF average higher than that of control group,both groups showed a trend of increasing over time, and the average change over time approaching.Conclusion The femtosecond laser-assisted cataract surgery compared with the conventional phacoemulsification cataract surgery has better visual quality. The femtosecond laser-assisted cataract surgery has a great clinical effects which improve patients visual quality early.