扭动模式超声乳化对年龄相关性白内障患者眼角膜的影响
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Effect of torsional mode phacoemulsification on cornea in patient with age-related cataract
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    摘要:

    目的:探讨扭动模式超声乳化对年龄相关性白内障患者眼角膜的影响。

    方法:选取我院2012-01/2014-12眼科住院的年龄相关性白内障患者161例196眼,按随机化原则分为扭动模式组(A组)和传统模式组(B组),晶状体核硬度按照Emery标准进行分级。记录术中所使用的有效超声时间(ultrasound time,UST)、有效累积释放能量(cumulative dissipated energy,CDE),并比较术后最佳矫正视力(best corrected visual acuity,BCVA)、眼角膜水肿程度(corneal edema degree,CED)、眼角膜中央厚度(central corneal thickness,CCT)和眼角膜内皮细胞丢失率。

    结果:两组患者各级核硬度手术中所使用的UST和CDE比较,A组较B组低。术后的平均最佳矫正视力比较,术后1、7d时A组较B组高,而术后30d两组差异无统计学意义(P>0.05)。眼角膜水肿和CCT比较,术后1、7d时A组较B组眼角膜水肿轻,平均CCT厚,术后30d两组患者差异无统计学意义(P>0.05)。术后7、30d平均眼角膜内皮细胞计数比较,A组较B组高,丢失率低。

    结论:由于缩短了术中UST和减少了CDE,扭动模式超声乳化减轻了对眼角膜内皮细胞的损伤,使得患者术后恢复周期缩短,但并未根本解决超声乳化对眼角膜造成的损伤。

    Abstract:

    AIM: To study the effect of torsional mode phacoemulsification on cornea in patient with age-related cataract.

    METHODS: Totally 161 age-related cataract patients(196 eyes)were assigned randomly to phacoemulsification by torsional mode(Group A)or conventional ultrasound mode(Group B)in our hospital from January 2012 to December 2014. The intraoperative data of effective ultrasound time(UST)and effective cumulative dissipated energy(CDE)were recorded. Postoperative outcomes and the change of the best corrected visual acuity(BCVA), corneal edema degree(CED), central corneal thickness(CCT)and endothelial cell count were also recorded and compared.

    RESULTS: For grade Ⅰ, Ⅱ, Ⅲ and Ⅳ nuclear density, the mean UST and mean CDE were significantly lower in Group A. The average BCVA of Group A was better than Group B at 1 and 7d after surgery. But at 30d postoperative, there was no statistical difference between these two groups(P>0.05). The corneal clarity and the mean change of central thickness showed significantly less corneal edema in Group A than Group B in 1 and 7d postoperatively. This difference was no longer found significantly at 30d after surgery(P>0.05). At 7 and 30d postoperative, the endothelial cells in Group B were lower than in Group A.

    CONCLUSION: By reducing the effective UST and CDE intraoperatively, the main effect of torsional mode phacoemulsification on cornea shows less damage to endothelium cells, and patients get better prognosis. But the damage to cornea by torsional mode phacoemulsification isn't fundamentally solved.

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李曼,谢桂军,任勇刚.扭动模式超声乳化对年龄相关性白内障患者眼角膜的影响.国际眼科杂志, 2017,17(8):1536-1539.

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  • 收稿日期:2017-03-07
  • 最后修改日期:2017-07-11
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  • 在线发布日期: 2017-07-24
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