轴性高度近视白内障飞秒激光辅助与传统超声乳化手术屈光预测准确性的对比

目的观察轴性高度近视（眼轴≥26 mm）合并白内障患者行飞秒激光辅助白内障超声乳化手术和行传统白内障超声乳化术术后屈光误差，比较其屈光预测准确性。方法前瞻性队列研究。收集白内障合并轴性高度近视患者63例（63眼），根据患者意愿对32例行传统超声乳化白内障联合囊袋内折叠式人工晶状体植入术（传统组），对31例行飞秒激光辅助白内障超声乳化联合囊袋内折叠式人工晶状体植入术（飞秒组）。记录2组患者预期术后屈光状态，实际术后1、3个月屈光状态以及2组视力情况，计算2组屈光误差（术后实际等效球镜度与预测屈光度的差值）和平均绝对屈光误差（术后实际等效球镜度与预测屈光度差值的绝对值）并进行组间比较，采用独立样本t检验、配对t检验、秩和检验对数据进行处理。结果2组患者术前一般情况（年龄、眼压、眼轴）差异均无统计学意义。术后1个月和3个月2组间的屈光误差、平均绝对屈光误差值（MAE）、裸眼视力（UCVA）及最佳矫正视力（BCVA）比较差异无统计学意义。术后3个月时2组患者共有16眼（25%）MAE超过1.0 D。术后3个月时2组的屈光误差及MAE与术后1个月比较，差异无统计学意义。结论飞秒激光辅助白内障超声乳化手术较传统手术方式在术后屈光度误差及术后矫正视力上无明显优势。

The accuracy of postoperative diopter in cataract patients with high myopia after femtosecond laser-assisted cataract surgery

Objective To compare the accuracy of postoperative diopter after femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery in cataract patients with high myopia.Methods In this prospective cohort study,63 cataract patients (63 eyes) with high myopia who underwent cataract surgery were enrolled.Patients were distributed into femtosecond laser-assisted cataract surgery (31 eyes) and conventional phacoemulsification cataract surgery (32 eyes).The predicted postoperative diopter,actual postoperative diopter at 1 month and 3 months were recorded,as well as uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).Refractive errors,mean absolute error (MAE) were calculated.Data were analyzed using independent t test,paired t test and rank sum test.Results The differences of patients' demographics parameters (age,intraocular pressure,axial length) were not significant between the two groups.The differences of refractive error,MAE,UCVA and BCVA at 1 month and 3 months postoperation were not significant between the two groups.The MAE of 16 eyes (25％) are greater than 1.0 D.The differences of refractive error and MAE in the two groups were not significant between 1 month and 3 months after surgery.Conclusion Femtosecond laser-assisted cataract surgery did not demonstrate clinically meaningful improvement in accuracy of postoperative diopter and visual acuity over tranditional phacoemulsification in high myopic patients.