[关键词]
[摘要]
目的:观察Infiniti超声乳化系统中智能超声(intelligent phacoemulsification,IP)应用于硬核白内障手术的有效性和安全性。
方法:前瞻性随机研究,选择年龄相关性白内障Ⅳ~Ⅴ级核患者92例92眼,随机分为两组,非IP组43例43眼,IP组49例49眼,分别在IP-OFF和IP-ON的模式下进行超声乳化白内障手术。术中记录两组超声乳化时间(ultrasound time,UST)和累积释放能量(cumulative dissipated energy,CDE)。术后第1、7d,3mo检查最佳矫正视力(best corrected visual acuity,BCVA),观察角膜水肿情况。术后第7d,3mo检查术眼的角膜中央内皮细胞密度和六角形细胞比例。
结果:IP组的UST为48.79±7.13s,非IP组为52.51±9.64s,两组比较差异有统计学意义(P=0.030),CDE在IP组为(14.29±2.77)%,低于非IP组的(15.78±3.73)%,两组比较差异有统计学意义(P =0.026)。术后第1d,IP组角膜水肿评分平均为2.61±0.64分,低于非IP组2.98±0.77分,两组比较差异有统计学意义(P=0.021); IP组79%术眼BCVA>0.1,高于非IP组56%术眼BCVA>0.1,两组比较差异无统计学意义(P=0.066),但有一定的临床意义。术后7d患者角膜水肿减轻,视力迅速提高,差异无统计学意义。术后7d角膜中央内皮细胞密度IP组为2 586.26±154.71个/mm2,高于非IP组的2 497.95±211.48个/mm2,且差异有统计学意义(P=0.029); 六角形细胞比例IP组为(48.33±8.69)%,高于非IP组的(44.19±9.48)%,两组比较差异有统计学意义(P=0.030)。
结论:在硬核白内障手术中,IP设置有机结合两种超声模式的优势,安全高效地减少对角膜内皮的损伤,有助于患者术后早期恢复视力。
[Key word]
[Abstract]
AIM: To compare the efficiency and safety of torsional phacoemulsification with or without intelligent phacoemulsification(IP)software in hard nucleus cataract extraction.
METHODS: Ninety two eyes with Ⅳ-Ⅴgrades cataracts were enrolled in this randomized prospective study. Operated eyes were divided into two groups-those operated without IP software(non-IP group, n=43)and those operated using IP software(IP group, n=49). The two groups were compared in terms of ultrasound time(UST)and cumulative dissipated energy(CDE). Post-operative outcome measures included the corneal edema and best-corrected visual acuity(BCVA)at 1,7d and 3mo postoperatively, corneal endothelial cell density and percentage of hexagonal cell at 7d and 3mo postoperatively.
RESULTS: UST was measured as 52.51±9.64s in non-IP Group and 48.79±7.13s in IP Group(P=0.030). CDE was 15.78±3.73% in non-IP Group and 14.29±2.77% in IP Group(P=0.026). At the first postoperative day, the rate of BCVA>0.1 in non-IP Group was 56%, and the rate in IP Group was 79%(P=0.066). Corneal edema in non-IP Group was 2.98±0.77 scores, and in IP Group it was 2.61±0.64 scores(P=0.021). At the postoperative 7 and 30d, the BCVA and corneal edema were no differences between two groups. At the postoperative 7d, corneal endothelial cell density in non-IP Group were 2497.95±211.48/mm2, less than 2586.26±154.71/mm2 in IP Group(P=0.029); percentage of hexagonal cell in IP group was 48.33±8.69%,higher than 44.19±9.48% of non-IP group(P=0.030).
CONCLUSION: In hard nucleus cataract extraction, the IP software can combine the advantages of the two kinds of ultrasonic modes, which is more effective with lower ultrasound energy and less injury for the corneal endothclium, and is helpful for the recovery of vision at early stage after surgeries.
[中图分类号]
[基金项目]