Femtosecond laser assisted cataract surgery versus conventional phacoemulsification: Refractive and aberrometric outcomes with a diffractive multifocal intraocular lens
Femtosecond laser assisted cataract surgery versus conventional phacoemulsification: Refractive and aberrometric outcomes with a diffractive multifocal intraocular lens
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DOI：
10.1016/j.jcrs.2018.08.032
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发表时间：
2019-01-01
影响因子：
2.8
通讯作者：
Tchah, Hungwon
中科院分区：
文献类型：
--
作者：
Lee, Jin Ah;Song, Woo Keun;Tchah, Hungwon
目的：比较常规超声乳化术与飞秒激光辅助白内障手术合并多焦人工晶状体植入术的疗效。地点：韩国首尔峨山医疗中心。设计：回顾性病例系列。方法：根据患者的喜好，选择飞秒激光辅助白内障手术或常规超声乳化手术。飞秒组角膜散光大于0.75屈光度的患者也行弓形角膜切开术。所有眼均行多焦点人工晶状体植入术。治疗1个月后，比较两组患者未矫正的远近视力、球面等效度、角膜和屈光散光、像差测量结果及问卷调查结果。并比较两组间靶性散光（TIA）和手术性散光（SIA）的相关性。结果：飞秒组17例（23眼），其中14眼行弓形角膜切开术。常规超声乳化术组22例（26眼）。飞秒组术前、术后角膜散光差异有统计学意义。TIA和SIA的相关性在飞秒组更大。飞秒激光组角膜均方根高阶像差（RMS HOAs） （P < 0.01）和总三叶草（P = 0.043）显著高于飞秒激光组。然而，飞秒组的内部总RMS （P = 0.05）、倾斜（P = 0.041）和RMS HOAs （P = 0.047）均显著降低。飞秒组的满意度得分明显更高。结论：飞秒激光辅助白内障手术组的散光改变更可预测。内部像差，包括总RMS、倾斜和RMS hoa，在飞秒组更低，患者更满意。（三）2018年ASCRS和ESCRS
Purpose: To compare the outcomes of conventional phacoemulsification and femtosecond laser-assisted cataract surgery followed by multifocal intraocular lens (IOL) implantation.Setting: Asan Medical Center, Seoul, South Korea.Design: Retrospective case series.Methods: Depending on their preference, patients had femtosecond laser-assisted cataract surgery or conventional phacoemulsification. Patients in the femtosecond group with corneal astigmatism greater than 0.75 diopter also had arcuate keratotomy. All eyes had multifocal IOL implantation. One month after treatment, the uncorrected distance and near visual acuities, spherical equivalent, corneal and refractive astigmatism, aberrometry results, and questionnaire results were compared between groups. Correlations between target-induced astigmatism (TIA) and surgically induced astigmatism (SIA) were also compared between the groups.Results: The femtosecond group comprised 17 patients (23 eyes), with arcuate keratotomy performed in 14 eyes. The conventional phacoemulsification group comprised 22 patients (26 eyes). In the femtosecond group, the difference in corneal astigmatism between preoperatively and postoperatively was statistically significant. The correlation between TIA and SIA was greater in the femtosecond group. Corneal root-mean-square higher-order aberrations (RMS HOAs) (P < .01) and total trefoil (P = .043) were significantly higher in the femtosecond laser group. However, internal total RMS (P = .05), tilt (P = .041), and RMS HOAs (P = .047) were significantly lower in the femtosecond group. Satisfaction scores were significantly higher in the femtosecond group.Conclusions: Astigmatic change was more predictable in the femtosecond laser-assisted cataract surgery group. Internal aberrations, including total RMS, tilt, and RMS HOAs, were lower in the femtosecond group, and patients in that group were more satisfied. (C) 2018 ASCRS and ESCRS