摘要
目的 探讨飞秒激光辅助超声乳化手术对白内障患者视力、眼压、前房深度和角膜内皮细胞(CECs)计数的影响。方法 回顾性选取2020年10月至2021年10月甘肃省康复中心医院收治的白内障患者213例,根据手术方式不同分为对照组103例和观察组110例。对照组给予超声乳化手术,观察组给予飞秒激光辅助超声乳化手术。观察两组术前、术后视力,眼压,前房深度,CECs计数和泪液炎症指标变化及并发症情况等。结果 (1)术后6、12周,两组裸眼视力、BCVA及前房深度均较术前显著增加,眼压较术前降低,差异均有统计学意义(P<0.05);术后6周,与对照组相比,观察组裸眼视力、BCVA及前房深度均显著增加,差异均有统计学意义(P<0.05),眼压比较差异无统计学意义(P> 0.05);术后12周,与对照组相比,观察组裸眼视力和前房深度均显著增加,差异均有统计学意义(P<0.05),而眼压和BCVA比较,差异均无统计学意义(P> 0.05)。(2)术后6、12周,两组CECs计数较术前显著减少,观察组CECs计数较对照组显著增加,差异均有统计学意义(P<0.05)。(3)术后6、12周,两组患者泪液炎症指标均较术前升高,差异均有统计学意义(P<0.05);术前、术后6周,两组泪液IL-6、TNF-α和TGF-β1水平比较,差异均无统计学意义(P> 0.05);术后12周,观察组泪液IL-6、TNF-α和TGF-β1水平均较对照组显著降低,差异均有统计学意义(P<0.05)。(4)观察组并发症总发生率2.19%,显著低于对照组(8.40%),差异有统计学意义(P<0.05)。结论飞秒激光辅助超声乳化手术组患者术后对患者眼部指标负面影响程度较小,术后患者角膜内皮细胞计数较普通超声乳化组损失减少,并发症发生率较低,并且长期来看患者泪液炎症水平较低,表明术后患者恢复情况较好,因此在临床具有较好应用价值。
Objective To investigate the effects of femtosecond laser combined with phacoemulsification on intraocular pressure,anterior chamber depth and corneal endothelial cells(CECs)in patients with cataract.Methods A total of 213 cataract patients admitted to Gansu Provincial Rehabilitation Center Hospital from October 2020 to October 2021 were retrospectively selected.According to different surgical methods,they were divided into a control group of 103 cases and an observation group of 110 cases.The control group was given phacoemulsification surgery,and the observation group was given femtosecond laser-assisted phacoemulsification surgery.The visual acuity,intraocular pressure,anterior chamber depth,CECs count,changes in tear inflammatory indexes,and complications before and after surgery were observed in the two groups.Results(1)At 6 and 12 weeks after operation,the uncorrected visual acuity,BCVA and anterior chamber depth in the two groups were significantly increased compared with those before operation,the intraocular pressure were lower than those before operation,and the differences were statistically significant(P<0.05);at 6 weeks after operation,compared with the control group,the uncorrected visual acuity,BCVA and anterior chamber depth of the observation group were significantly increased,and the differences were statistically significant(P<0.05),and there was no significant difference between the intraocular pressure and the preoperative intraocular pressure(P>0.05);at 12 weeks after operation,compared with the control group,the uncorrected visual acuity and anterior chamber depth in the observation group were significantly increased,and the differences were statistically significant(P<0.05),but there was no statistically significant difference in intraocular pressure and BCVA(P>0.05).(2)There was no significant difference in CECs count between the two groups before surgery(P>0.05);the number of CECs in the two groups at 6 and 12 weeks after operation was significantly lower than that before operation,and the CECs counts in the observation group at 6 weeks to 12 weeks after operation were significantly increased compared with those in the control group,and the differences were statistically significant(P<0.05).(3)At 6 weeks and 12 weeks after operation,the tear inflammatory indexes of the two groups were higher than those before operation,and the differences were statistically significant(P<0.05).Before operation and 6 weeks after operation,there was no significant difference in the levels of IL-6,TNF-αand TGF-β1 in tears between the two groups(P>0.05);at 12 weeks after operation,the levels of IL-6,TNF-αand TGF-β1 in the tears of the observation group were significantly lower than those of the control group,and the differences were statistical significance(P<0.05).(4)The total incidence of complications in the observation group was 2.19%,which was significantly lower than that in the control group(8.40%),and the difference was statistical significance(P<0.05).Conclusion The femtosecond laser-assisted phacoemulsification group has less negative impact on the patient's ocular indicators after surgery,and the corneal endothelial cell count of the patients after surgery is lower than that of the ordinary phacoemulsification group,and the incidence of complications is lower.The lower level of tear inflammation indicates that the postoperative recovery of patients is better,so it has better clinical application value.
作者
常彩霞
王登廷
郑吉琦
张梅
CHANG Cai-xia;WANG Deng-ting;ZHENG Ji-qi(Department of Ophthalmology,Gansu Provincial Rehabilitation Center Hospital,Lanzhou Gansu 730000,China)
出处
《临床和实验医学杂志》
2022年第15期1660-1664,共5页
Journal of Clinical and Experimental Medicine
基金
甘肃省科技厅重点研发计划(编号:20YF8FA111)。
关键词
白内障
超声乳化术
飞秒激光
眼压
前房深度
角膜内皮细胞计数
泪液炎症指标
Cataract
Phacoemulsification
Femtosecond laser
Intraocular pressure
Anterior chamber depth
Corneal endothelial cell count
Tear inflammatory index
