【摘要】：目的通過測量并比較飛秒激光前囊膜切開術(shù)與連續(xù)環(huán)形撕囊術(shù)術(shù)后患者前囊口形態(tài)、大小和位置參數(shù),評估其對人工晶狀體居中性的影響。方法收集了2015年3月至2016年7月在我院行白內(nèi)障手術(shù)的年齡相關(guān)性白內(nèi)障患者80例(80眼),其中飛秒組40例(40眼),患者行飛秒激光前囊膜切開術(shù);手工組40例(40眼),患者行手工連續(xù)環(huán)形撕囊術(shù)。兩組患者年齡、性別構(gòu)成、眼軸長度和等效球鏡度數(shù)差異均無統(tǒng)計學(xué)意義(均為P0.05),具有可比性。兩組術(shù)后1周、1個月、1 a復(fù)查用數(shù)字化裂隙燈照相和Pentacam眼前節(jié)分析儀采集眼前節(jié)圖像,用Image-Pro-Plus 6.0圖像分析軟件來測量前囊口的水平和垂直直徑、圓度、囊膜緣包裹人工晶狀體光學(xué)部的最大和最小距離、包裹度。運用重復(fù)測量方差分析、確切概率法、廣義估計方程模型來分析兩組間參數(shù)差異和人工晶狀體居中性預(yù)測因子。結(jié)果飛秒組和手工組術(shù)后1周、1個月,兩組間垂直直徑、圓度、最大距離、最小距離、包裹度、水平偏移,差異均有統(tǒng)計學(xué)意義(均為P0.05);兩組間水平直徑、垂直偏移,差異均無統(tǒng)計學(xué)意義(均為P0.05)。術(shù)后1 a,兩組間最大距離、最小距離、包裹度、水平偏移,差異均有統(tǒng)計學(xué)意義(均為P0.05);兩組間垂直和水平直徑、圓度、垂直偏移,差異均無統(tǒng)計學(xué)意義(均為P0.05)。在飛秒組中,術(shù)后1周、1個月、1 a水平偏移均未出現(xiàn)≥0.4 mm者;在手工組中,術(shù)后1周、1個月、1 a水平偏移≥0.4 mm眼數(shù)和0.4 mm眼數(shù)比分別為2/38、4/36、8/32。術(shù)后1 a,兩組水平偏移≥0.4 mm的分布差異有統(tǒng)計學(xué)意義(P0.05)。在單變量廣義估計方程模型中,撕囊類型是水平偏移的顯著預(yù)測因子。而在所有的撕囊參數(shù)中,僅包裹度差異有統(tǒng)計學(xué)意義(P=0.001)。術(shù)后1周、1個月、1 a飛秒組包裹度與水平偏移均存在負(fù)相關(guān)性(r=-0.89,P0.05;r=-0.72,P0.05;r=-0.58,P0.05);術(shù)后1周手工組包裹度與水平偏移亦存在負(fù)相關(guān)性(r=-0.68,P0.05),而術(shù)后1個月、1 a手工組包裹度與水平偏移均無相關(guān)性(r=-0.41,P0.05;r=-0.33,P0.05)。結(jié)論飛秒激光前囊膜切開術(shù)制作的前囊口更圓、更居中,大小更精準(zhǔn),囊袋內(nèi)人工晶狀體位置更穩(wěn)定,居中性更好。
[Abstract]:Objective to evaluate the effect of femtosecond laser anterior capsule incision on intraocular lens (IOL) by measuring and comparing the shape, size and location of anterior capsule orifice after femtosecond laser anterior capsule incision and continuous circular capsulorhexis. Methods from March 2015 to July 2016, 80 patients (80 eyes) with age-related cataract underwent cataract surgery in our hospital. 40 patients (40 eyes) in femtosecond group were treated with femtosecond laser anterior capsulorotomy. 40 cases (40 eyes) of manual group were treated with continuous circular capsulorhexis. There were no significant differences in age, sex composition, axial length and equivalent spherical degree between the two groups (P0.05). The anterior segment images were collected by digital slit lamp photography and Pentacam anterior segment analyzer 1 week, 1 month and 1 year after operation. The horizontal and vertical diameter and roundness of anterior capsule orifice were measured by Image-Pro-Plus 6.0 image analysis software. The maximum and minimum distance and degree of encapsulation of the optical part of the intraocular lens wrapped by the capsule rim. Repeated measurement variance analysis, exact probability method and generalized estimation equation model were used to analyze the difference of parameters between the two groups and the population neutral predictor of intraocular lens (IOL). Results there were significant differences in vertical diameter, roundness, maximum distance, minimum distance, wrapping degree and horizontal deviation between femtosecond group and manual group 1 week and 1 month after operation (P0.05). The difference was not statistically significant (P0.05). After 1 year, the maximum distance, minimum distance, wrapping degree, horizontal deviation between the two groups were statistically significant (P0.05); the vertical and horizontal diameter, roundness, vertical deviation between the two groups were not statistically significant (P0.05). In femtosecond group, 1 month or 1 month after operation, no horizontal deviation 鈮，

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