| Background:Femtosecond laser-assisted cataract phacoemulsification(FLACS)has been observed to cause intraoperative pupil narrowing and intraocular pressure increase since it was first reported in 2009.The changes of pupil diameter and intraocular pressure are directly related to the subsequent surgical operation and the occurrence of surgical complications,and the important time period of subsequent surgery is within 30 minutes after femtosecond laser treatment.At present,the study has not involved the changes of pupil diameter and intraocular pressure within 30 minutes after femtosecond laser treatment.Understanding the changes in this long period of time is helpful for surgeons to control the operation time allocation and safety.Studies have found that the increased concentration of inflammatory factors in the aqueous humor of patients with FLACS is closely related to the narrowing of pupil diameter,and the reason for the increased intraocular pressure may also be related to the release of inflammatory factors.Therefore,non-steroidal anti-inflammatory drugs(NSAIDs)are routinely pretreated before surgery to prevent the narrowing of pupil diameter during FLACS.The effect of 0.1% pranoprofen on pupil diameter and intraocular pressure changes within 30 minutes after FLACS femtosecond laser treatment of NSAIDs as a routine topical ophthalmic use is also noteworthy.No research has been done.Purpose:To observe the effect on the subsequent phacoemulsification and Intraocular lens implantation by the variation of pupil diameter(PD)and intraocular pressure(IOP)after femtosecond laser treatment within 30 minutes.And to explore whether the application of 0.1% pranoprofen could significantly reduce the miosis and increased IOP caused by femtosecond laser treatment in femtosecond laser-assisted cataract surgery(FLACS)and Whether it can significantly reduce the incidence of pupil narrowing and intraocular pressure increase caused by femtosecond laser treatment.Methods:This study was based on the test results of 288 eyes(149 right,139 left)from 288 patients among the 375 patients recruited.The patients were randomly divided into two groups by the random numbers: the trial group received 0.1% pranoprofen four times a day prior to surgery,whereas the control group did not receive 0.1% pranoprofen pretreatment.The PD and IOP were measured at different time points within 30 minutes after the completion of the femtosecond laser treatment.Within each sub-group,the PD and IOP at each time point after the completion of the femtosecond laser treatment were compared with the baseline(PD Ⅰ,IOP Ⅰ)by the repeated measures analysis of variance and independent t test.Pairwise comparisons between the two groups(the control group and trial group)at each time point after the completion of the femtosecond laser treatment of PD and IOP were analyzed.Results:1.The PD group: in the control group without pretreatment of 0.1% pranoprofen,compared with PD Ⅰ,the PD at the time point after femtosecond laser treatment within 30 minutes decreased and increased then decreased again.The PD during the femtosecond laser treatment(PD Ⅱ),15 minutes(PD Ⅳ)and 30 minutes(PD Ⅴ)after the completion of femtosecond laser treatment decreased significantly compared with PD Ⅰ(p < 0.05),only at the completion of femtosecond laser treatment(PD Ⅲ)increased slightly but not significantly(p > 0.05).In the trial group with pretreatment of 0.1% pranoprofen,the PD showed the same fluctuation as in control group,but the PD in the process of the femtosecond laser treatment(PD Ⅱ)was significantly decreased(p < 0.05),and the other time points were not statistically significant(p > 0.05).Pairwise comparisons of the control group and trial group showed that the PD of patients pretreated with 0.1% pranoprofen(7.88±0.85 mm)was significantly larger than that of the control group(7.59±1.08 mm)only at 15 minutes(PD Ⅳ)after FLACS(P =0.046)2.The IOP group: in the control group without pretreatment of 0.1% pranoprofen,compared with IOP Ⅰ,the IOP at each time point after femtosecond laser treatment within 30 minutes increased(with slight fluctuation).All the IOPs after femtosecond laser treatment(IOP Ⅱ-Ⅳ)increased significantly when compared with IOP Ⅰ(P<0.05).In the trial group with pretreatment of 0.1% pranoprofen,the IOP showed the same fluctuation as in control group,but only at the 15 minutes after the completion of femtosecond laser treatment(IOP Ⅲ)increased not significantly(p > 0.05),others were statistically significant(p < 0.05).Pairwise comparisons of the control group and trial group showed that the IOPs were no significant difference in IOP at any time point(P >0.05).3.The ratio of significant miosis(PD ≤ 5 mm)was not significantly different between the control group(2%)and the trial group(1%)(P >0.05).The proportion of patients with intraocular hypertension(IOP ≥ 30 mm Hg)was 6.94% in the control group and 4.17% in the trial group,and they were not significant(P >0.05).Conclusions:The PD and IOP of patients undergoing FLACS showed fluctuations within a small range,the rates of significant miosis and high intraocular pressure are only 1.50% and 5.56%,the effect on phacoemulsification and intraocular lens implantation is small,and it is safe for surgeons to complete the follow-up procedures within 30 minutes after femtosecond laser treatment.Pretreatment with 0.1% pranoprofen exerted a modest,albeit significant,prophylactic effect.However,pretreatment with 0.1% pranoprofen provided only a limited benefit in patients undergoing FLACS without other complications. |
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