A randomized controlled trial of peeling and aspiration of Elschnig pearls and neodymium: yttrium-aluminiumgarnet laser capsulotomy

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摘要 AIM:Tocomparesurgicalpeelingandaspirationandneodymiumyttriumgarnetlasercapsulotomyforpearlformofposteriorcapsuleopacification(PCO).METHODS:Aprospective,randomized,doubleblind,studywasdoneatRotaryEyeHospital,Maranda,Palampur,India,SantoshMedicalCollegeHospital,Ghaziabad,IndiaandLaserEyeClinic,NoidaIndia.ConsecutivepatientswithpearlformofPCOfollowingsurgery,phacoemulsification,manualsmallincisioncataractsurgeryandconventionalextracapsularcataractextraction(ECCE)foragerelatedcataract,wererandomizedtohavepeelingandaspirationorneodymiumyttriumgarnetlasercapsulotomy.Correcteddistancevisualacuity(CDVA),intra-operativeandpostoperativecomplicationswerecompared.RESULTS:Atotalof634patientsparticipatedinthestudy,and314(49.5%)patientswererandomizedtosurgicalpeelingandaspirationgroupand320(50.5%)totheNd:YAGlasergroup.Themeanpre-procedurallogMARCDVAinpeelingandneodymium:yttrium-aluminium-garnet(Nd:YAG)lasergroupwas0.80±0.25and0.86±0.22,respectively.ThemeanfinalCDVAinpeelinggroup(0.22±0.23)wascomparabletoNd:YAGgroup(0.24±0.28;t-test,P=0.240).Therewasasignificantimprovementinvisionafterboththeprocedures(P<0.001).AslightlyhigherpercentageofpatientsinNd:YAGlasergroup(283/88.3%)thaninpeelinggroup(262/83.4%)hadaCDVAof0.5(20/63)orbetterat9mo(P<0.001).Onthecontrary,patientshavingCDVAworsethan1.00(20/200)wasalsosignificantlyhigherinNd:YAGlasergroupascomparedtopeelinggroup(25/7.7%vs15/4.7%,respectively).OnapplicationofANCOVA,therewaslessthan0.001%riskthatPCOthicknessandtotallaserenergyhadnoeffectonrateofcomplicationsinNd:YAGlasergroupandlessthan0.001%riskthatPCOthicknesshadnoeffectoncomplicationsinpeelinggrouprespectively.SumofsquareanalysissuggeststhatintheNd:YAGlasergroup,thickPCOhadastrongerimpactoncomplications(Fischertestprobability,Pr<0.0001)
机构地区 不详
出版日期 2015年03月13日(中国期刊网平台首次上网日期,不代表论文的发表时间)
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