比较21G弯头和直头在横向劈核微切口同轴超声乳化手术中的应用

Comparison of 21G curved and straight phacotips designs in transversal microcoaxial phacoemulsification

摘要:

目的：比较在微切口同轴扭动超声乳化使用直头和弯头的术中表现和术后结果。

方法：白内障患者行2.2mm横向劈核微切口同轴超声乳化术中使用30° 直头或弯头进行治疗。术中检查分析包括平均超声功率，总超声乳化时间，有效的超声乳化时间。使用非接触镜显微镜评估术前和术后1d， 7d和30d的中央内皮细胞密度和角膜中央厚度。

结果：此研究共纳入白内障患者190例190眼，95眼为弯头组，95眼为直头组。术中检查显示弯头组总超声乳化时间和有效的超声乳化时间较直头组显著降低(P<0.05)。弯头组总超声乳化时间和有效的超声乳化时间中位数分别为25.9(13.5-45.0)s(四分位间距)和18.0(9.0-30.0)s，直头组分别为38.8(16.5-73.5)s和26.0(11.0-49.0)s。

结论：横向劈核微切口同轴超声乳化术中，相比较直头，使用弯头可以更加有效的摘除晶体，在所有阶段中除了第四阶段，总超声乳化时间和有效的超声乳化时间更短。

Abstract:

AIM:To compare the intraoperative performance and postoperative outcomes after microcoaxial torsional phacoemulsification using the straight and the curved phacotip configurations.

METHODS:Cataracts were treated using 2.2mm microcoaxial transversal phacoemulsification with either a 30°straight or 30° curved phaco tip. Intraoperative measurements analyzed included the average ultrasound(U/S)power, the total phacoemulsification time, and the effective phacoemulsification time(EPT). The central endothelial cell density(ECD)and the central corneal thickness(CCT)were evaluated preoperatively and postoperatively at 1, 7 and 30d after surgery using noncontact specular microscopy.

RESULTS:The study enrolled a total of 190 eyes(190 patients), 95 eyes in the curved tip group and 95 eyes in straight tip group. Intraoperative measurements showed significantly reduced total phacoemulsification time, and EPT in the curved-tip group, compared to the straight-tip group(P<0.05). The median total phacoemulsification time and the EPT were 25.9(13.5-45.0)s(1^st-3^rd quartiles)and 18.0(9.0-30.0)s in curved-tip group, and 38.8(16.5-73.5)s and 26.0(11.0-49.0)s in the straight-tip group, respectively.

CONCLUSION:Transversal phacoemulsification performed with a curved tip provided more effective lens removal with a less total UST and EPT in all grades, except for grades IV, compared to a straight tip.