Factors affecting corneal incision position during femtosecond laser-assisted cataract surgery
Factors affecting corneal incision position during femtosecond laser-assisted cataract surgery
复制标题
DOI：
10.1016/j.jcrs.2017.09.024
复制
发表时间：
2017-12-01
影响因子：
2.8
通讯作者：
Meades, Kerrie
中科院分区：
文献类型：
--
作者：
Bala, Chandra;Chan, Thomas;Meades, Kerrie
目的：比较飞秒激光辅助白内障手术中角膜切口的预期位置和尺寸与实际位置和尺寸。设置：Private Ophthalmic Clinic，Sydney，NSW，Australia。设计：回顾性病例系列。方法：回顾使用Lensx激光进行飞秒激光辅助白内障手术的视频记录。主切口和2个次级切口与预期位置的偏差与地球仪倾斜、地球仪位移和生物特征数据相关。地球仪倾斜度由前囊倾斜度推断。测量地球仪位移。Softfit接触透镜厚度中使用的患者interfacesindependent.Results：主要切口的内部和外部出口分别在142 μ m +/- 70（SD）和151 +/- 75 μ m的计划位置。尺寸和位置与生物特征变量无关。上级二级切口外部出口向中心移位（321 +/- 84 μ m），内部出口向周边移位（84 +/- 102 μ m）。下方次级切口外部出口向中心移位（278 +/- 142 μ m），内部出口向周边移位（190 +/- 133 μ m）。多因素分析显示，上级的外部和内部退出（校正后r（2）= 0.36，P < .001; r（2）= 0.15，P < .001）和下方二次切口（r（2）= 0.67，P < .001; r（2）= 0.46，P < .001）与地球仪倾斜和移位相关。初次切口接近预期尺寸。二次切口位置受眼球倾斜和偏心对接的影响。这些都可以通过光学相干断层扫描引导来改善。
Purpose: To compare the expected versus actual position and dimension of corneal incisions during femtosecond laser-assisted cataract surgery.Setting: Private Ophthalmic Clinic, Sydney, NSW, Australia.Design: Retrospective case series.Methods: Video recordings of femtosecond laser-assisted cataract surgery with a Lensx laser were reviewed. The deviation of the main and 2 secondary incisions from the expected position were correlated with globe tilt, globe displacement, and biometric data. The globe tilt was inferred from anterior capsule tilt. Globe displacement was measured. The Softfit contact lens thickness used in the patient interface was measured separately.Results: The primary incision internal and external exits were within 142 mu m +/- 70 (SD) and 151 +/- 75 mu m of the planned position. The dimensions and position did not correlate with biometric variables. The superior secondary incision external exit was displaced centrally (321 +/- 84 mu m) and the internal exit was displaced peripherally (84 +/- 102 mu m). The inferior secondary incision external exit was displaced centrally (278 +/- 142 mu m) and the internal exit was displaced peripherally (190 +/- 133 mu m). Multivariate analysis showed that the external and internal exits of the superior (adjusted r(2) = 0.36, P < .001; r(2) = 0.15, P < .001) and inferior secondary incisions (r(2) = 0.67, P < .001; r(2) = 0.46, P < .001) correlated with globe tilt and displacement.Conclusions: The primary incisions were close to the expected dimensions. The secondary incision position was affected by eye tilt and eccentric docking. These could potentially be improved with optical coherence tomography guidance.