Femtosecond laser capsulotomy
Femtosecond laser capsulotomy
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DOI：
10.1016/j.jcrs.2011.04.022
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发表时间：
2011-07-01
影响因子：
2.8
通讯作者：
Culbertson, William W.
中科院分区：
文献类型：
--
作者：
Friedman, Neil J.;Palanker, Daniel V.;Culbertson, William W.
目的：评价一种飞秒激光系统创建囊切开术。地点：猪眼和尸体眼研究在美国加利福尼亚州圣克拉拉的OptiMedica公司进行；人体试验在多米尼加共和国圣多明各的激光中心进行。设计：实验和临床研究。方法：利用光学相干断层扫描引导飞秒激光对猪和人尸体眼睛进行包膜切开术。随后，39名患者接受了该手术，作为飞秒激光辅助白内障手术前瞻性随机研究的一部分。我们量化了切开囊膜的大小、形状和浓度的准确性，并评估了切开囊膜在猪眼中的强度。结果：激光创建的囊切开术在大小和形状上比手动创建的囊切开术更精确。在患者眼中，激光技术与切除囊盘的预期直径的偏差为29 μ m +/- 26 (SD)，手工技术为337 +/- 258 μ m。与圆度的平均偏差分别为6%和20%。激光包膜切开术中心距预定位置在77±47 μ m以内。所有的包膜切开均完成，无桡骨切口或撕裂。激光切囊强度（猪亚组）随脉冲能量的增加而降低：3亩J为152 +/- 21 mN， 6亩J为121 +/- 16 mN， 10亩J为113 +/- 23 mN，手动切囊强度为65 +/- 21 mN。结论：飞秒激光切开术比传统手工切开术更精确、准确、可重复性好、切开术强度大。
PURPOSE: To evaluate a femtosecond laser system to create the capsulotomy.SETTING: Porcine and cadaver eye studies were performed at OptiMedica Corp., Santa Clara, California, USA; the human trial was performed at the Centro Laser, Santo Domingo, Dominican Republic.DESIGN: Experimental and clinical study.METHODS: Capsulotomies performed by an optical coherence tomography guided femtosecond laser were evaluated in porcine and human cadaver eyes. Subsequently, the procedure was performed in 39 patients as part of a prospective randomized study of femtosecond laser-assisted cataract surgery. The accuracy of the capsulotomy size, shape, and centration were quantified and capsulotomy strength was assessed in the porcine eyes.RESULTS: Laser-created capsulotomies were significantly more precise in size and shape than manually created capsulorhexes. In the patient eyes, the deviation from the intended diameter of the resected capsule disk was 29 mu m +/- 26 (SD) for the laser technique and 337 +/- 258 mu m for the manual technique. The mean deviation from circularity was 6% and 20%, respectively. The center of the laser capsulotomies was within 77 +/- 47 mu m of the intended position. All capsulotomies were complete, with no radial nicks or tears. The strength of laser capsulotomies (porcine subgroup) decreased with increasing pulse energy: 152 +/- 21 mN for 3 mu J, 121 +/- 16 mN for 6 mu J, and 113 +/- 23 mN for 10 mu J. The strength of the manual capsulorhexes was 65 +/- 21 mN.CONCLUSION: The femtosecond laser produced capsulotomies that were more precise, accurate, reproducible, and stronger than those created with the conventional manual technique.