第一眼和第二眼飞秒激光辅助白内障手术后的痛觉、眼液细胞因子和瞳孔反应:一项随机、前瞻性、个体内研究。

IF 4.9 2区 医学 Q1 OPHTHALMOLOGY Clinical and Experimental Ophthalmology Pub Date : 2024-08-12 DOI:10.1111/ceo.14426
Yinhui Yu, Lixia Wang, Yue Qiao, Yang Ye, Yueyang Zhong, Xiaohui Song, Ke Yao, Yibo Yu
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引用次数: 0

摘要

背景:目的:比较第一眼和第二眼飞秒激光辅助白内障手术(FLACS)过程中的痛觉、瞳孔行为和细胞因子水平,并确定双侧FLACS间隔时间短或长哪个更好:48名双侧白内障患者的96只眼睛按照随机顺序接受了左眼或右眼的首次手术。根据手术间隔,他们被进一步随机分为 2 周和 6 周两组。瞳孔大小通过捕捉到的图像进行测量,疼痛感则通过视觉模拟量表(VAS)进行评估。此外,还定量分析了泪液中前列腺素 E2 (PGE2)、单核细胞趋化蛋白-1 (MCP-1)、白细胞介素 (IL)-6 和 IL-8 的水平。对所有患者进行为期一周的随访,以评估内皮细胞密度(ECD)、角膜中央厚度(CCT)和黄斑中央子场厚度(CST)的变化:结果:接受第二眼FLACS的患者眼部疼痛明显加剧。第一滴泪破裂时间与 VAS 评分呈负相关。第二眼 FLACS 患者的 MCP-1 水平明显更高,所有患者的 VAS 评分与 MCP-1 水平呈正相关。在 miosis、PGE2、IL-6、IL-8 水平以及术后 ECD、CCT 和 CST 的变化方面,连续 FLACS 之间没有差异。6周后接受第二眼FLACS的患者CCT、CST和MCP-1的变化比基线更大:结论:第二眼 FLACS 会导致更多疼痛,并使 MCP-1 上调。在 PGE2 水平、瞳孔缩小和术后炎症方面,连续的 FLACS 之间没有差异。此外,第一眼 FLACS 会引发交感神经刺激,尤其是在间隔 6 周之后。
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Pain perception, aqueous humour cytokines, and miosis response following first and second eye femtosecond laser-assisted cataract surgery: A randomised, prospective, intraindividual study.

Background: To compare pain perception, pupil behaviours, and cytokine levels during first-eye and second-eye femtosecond laser-assisted cataract surgery (FLACS) and determine which is better regarding a short or long interval for bilateral FLACS.

Methods: Notably, 96 eyes of 48 patients with bilateral cataracts underwent the first surgeries in the left or right eye, according to a random sequence. They were further randomised into 2- and 6-week subgroups based on surgery intervals. Pupil size was measured from captured images, and pain perception was assessed using a visual analog scale (VAS). Aqueous humour prostaglandin E2 (PGE2), monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6, and IL-8 levels were also quantitatively analysed. All patients were followed for 1 week to evaluate changes in endothelial cell density (ECD), central corneal thickness (CCT), and macular central subfield thickness (CST).

Results: Ocular pain was significantly higher in patients who underwent second-eye FLACS. First tear break-up time was negatively correlated with VAS score. MCP-1 levels were significantly higher in patients who underwent second-eye FLACS, and VAS scores were positively correlated with MCP-1 levels across all patients. There were no differences between sequential FLACS in miosis, PGE2, IL-6, IL-8 levels and changes in postoperative ECD, CCT, and CST. Patients who underwent second-eye FLACS after 6 weeks showed more CCT, CST, and MCP-1 changes than baseline.

Conclusion: Second-eye FLACS causes more pain and upregulated MCP-1. There was no difference between sequential FLACS in PGE2 levels, miosis, and postoperative inflammation. Furthermore, first-eye FLACS triggered a sympathetic irritation, particularly after a 6-week interval.

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来源期刊
CiteScore
7.60
自引率
12.50%
发文量
150
审稿时长
4-8 weeks
期刊介绍: Clinical & Experimental Ophthalmology is the official journal of The Royal Australian and New Zealand College of Ophthalmologists. The journal publishes peer-reviewed original research and reviews dealing with all aspects of clinical practice and research which are international in scope and application. CEO recognises the importance of collaborative research and welcomes papers that have a direct influence on ophthalmic practice but are not unique to ophthalmology.
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