摘要
目的:在白内障超声乳化手术中应用针刺预劈核技术,并与传统核处理方式进行比较,探讨该项技术在硬核白内障超声乳化手术中的优缺点。方法:选取2015-04/2016-08于我院行白内障超声乳化手术(核硬度Ⅲ~Ⅳ级)126例158眼,随机分为预劈核组(A组)58例76眼和传统乳化组(B组)68例82眼。A组在进行超声乳化核处理前先进行针刺预劈核。分别记录术中平均超声能量(AP)、实际超声乳化时间(U/S time)、累积能量复合参数(AECP)、术中并发症,以及术前和术后平均角膜内皮细胞密度、平均角膜内皮细胞丢失率、裸眼视力和角膜水肿等情况,并进行组间比较。结果:A组的AP,U/Stime,AECP均低于B组,差异有统计学意义(P<0.05);术后1d,Ⅳ级核A组角膜水肿轻于B组,裸眼视力Ⅳ级核预劈核组也优于传统超乳组,差异有统计学意义(P<0.05),而术后1wk裸眼视力组间比较无统计学意义(P>0.05)。术后1wk,B组平均角膜内皮细胞密度均低于A组,角膜内皮细胞丢失率高于A组,差异有统计学意义(P<0.05)。术中出现晶状体后囊膜破裂A组2眼,B组有4眼。结论:与传统乳化劈核相比,针刺预劈核联合乳化劈核术中超声时间更短、能量更低、术后角膜内皮细胞丢失更少、术后早期裸眼视力更好。
AIM：To discuss the effect of the cystotome-assisted prechop technique performed in hard nuclear cataract phacoemulsification.METHODS：One hundred and twenty-six patients（158eyes） of age-related cataracts with nucleus density at grade Ⅲ-Ⅳ were randomly divided into two groups.Group A was performed a manual prechop technique using a surgeon-bent cystotome after the capsulorhexis,while group B was performed traditional phaco-chop without prechop technique.The average power（AP）,actual ultrasonic time（U/S time）,accumulated energy complex parameter（AECP） of machine,average density of endothelial cells,endothelial cells loss,uncorrected visual acuity（UCVA）,corneal edema and intraoperative complications were compared between groups.RESULTS：The AP,U/S time and AECP of Group A were significantly lower than that of Group B（P0.05）.At postoperative day 1,the corneal edema of Group A was slighter than the control with significant difference（P0.05）,so was the UCVA.While there was no significant difference of UCVA between groups at postoperative 1wk.The average corneal endothelium density of Group B was significantly lower than that of Group A at postoperative1 wk,and the average cell loss was higher than that of Group A.Two eyes of group A had posterior capsular rupture compared to 4 eyes of Group B.CONCLUSION：Compared with traditional phaco-chop,the cystotome-assisted prechop technique presents shorter intraoperative ultrasound time and lower energy,while contributes to less corneal endothelial cell loss and better early postoperative UCVA.
出处
《国际眼科杂志》
CAS
2017年第3期474-477,共4页
International Eye Science
关键词
白内障
超声乳化
预劈核
cataract
phacoemulsification
prechop
