Long-term visual field changes after femtosecond laser-assisted cataract surgery in glaucoma patients, case series.
Long-term visual field changes after femtosecond laser-assisted cataract surgery in glaucoma patients, case series.
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DOI：
10.1016/j.ajoc.2021.101163
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发表时间：
2021-09
影响因子：
--
通讯作者：
Castañeda-Diez R
中科院分区：
文献类型：
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作者：
Alvarez-Ascencio D;Prado-Larrea C;Jimenez-Roman J;Castañeda-Diez R
评估青光眼患者行飞秒激光辅助白内障手术（FLACS）后视野（VF）平均偏差（MD）、视野指数（VFI）和眼压（IOP）的短期和长期变化。干预性、前瞻性病例系列。纳入了需要白内障手术的青光眼患者。所有患者均接受了完整的眼科评估和视野检查。FLACS由一名经验丰富的外科医生在所有患者中进行。在手术过程中，在预处理吸引对接之前和之后立即测量IOP。随访1年，评价VF MD和VFI、IOP、视力（VA）和青光眼药物治疗数量较基线的变化。纳入11例患者的14只眼。85%为女性，平均年龄为74.2 ± 7.9岁。原发性闭角型青光眼（PACG）9例（64.3%），原发性开角型青光眼（POAG）5例（35.7%）。我们发现，在FLACS期间，两个青光眼亚型组的对接阶段后，IOP略有降低。两组的视野平均偏差（MD）和视野指数（VFI）从基线到术后12个月均无显著变化。从基线到一年随访，所有病例的IOP值均显著降低。一年后，两组的BCVA和局部青光眼药物的数量均无显著变化。在我们的患者中，抽吸对接FLACS预处理后眼压立即降低。最终随访时的平均IOP显示较基线降低。从基线到最终1年随访，VF MD和VFI没有变化。FLACS似乎在早期和中度青光眼中耐受良好，并且似乎是接受白内障手术的青光眼患者的安全工具。利用飞秒激光精确度的优势，可以获得与传统手术相似的结果。
To assess the short and long-term changes in Visual Field (VF) Mean Deviation (MD), Visual Field Index (VFI), and intraocular pressure (IOP) after femtosecond laser-assisted cataract surgery (FLACS) in glaucomatous eyes. Interventional, prospective case series. Patients with glaucoma, who required cataract surgery were included. All patients underwent a complete ophthalmologic assessment and Visual Fields. FLACS was performed in all patients by a single experienced surgeon. IOP was measured during surgery immediately before and after pretreatment suction docking. Changes from baseline in VF MD and VFI, IOP, visual acuity (VA), and number of glaucoma medications were evaluated up to one-year follow-up. Fourteen eyes of 11 patients were included. Eighty-five percent were female, with a mean age of 74.2 ± 7.9 years. Nine (64.3%) and 5 (35.7%) were diagnosed with primary angle closure glaucoma (PACG) and primary open angle glaucoma (POAG), respectively. We found a slight IOP reduction after the docking phase during FLACS in both glaucoma subtype groups. No significant changes in visual field mean deviation (MD) and visual field index (VFI) were found from baseline to 12 months after surgery in both groups. A significant reduction in IOP values was found in all cases from baseline up to one year follow up. No significant changes were observed in BCVA and number of topical glaucoma medications after one year in both groups. In our patients, there was an IOP reduction immediately after suction docking FLACS pretreatment. Mean IOP at final follow-up showed a reduction from baseline. There was no change in VF MD and VFI from baseline to final one-year follow-up. FLACS appears to be well tolerated in early and moderate glaucoma and appears to be a safe tool for glaucoma patients undergoing cataract surgery. Similar results to traditional surgery can be obtained with the advantages of femtosecond laser precision.