摘要
目的 通过改进白内障超声乳化吸除术的手术技术来缩短超声时间和降低实际超声能量 ,以减少超声振荡波对角膜内皮的损伤 ,提高手术操作的效率及安全性。方法 采用细分核、高负压及高流量抽吸技术和 Stop Chop法对 5 74例 6 0 0眼 ～ 级核老年性白内障患者进行手术 ,分析对比这两种方法所需的超声时间、实际超声能量、术前及术后一周的角膜内皮细胞计数、术后角膜内皮水肿混浊的程度和发生率。结果 与 Stop Chop法相比 ,采用细分核、高负压及高流量抽吸技术 ,手术所需的超声时间 级核平均下降 33% , 级核平均下降 30 % , 级核平均下降 33% ;实际超声能量 级核平均下降 2 1% , 级核平均下降 2 0 % , 级核平均下降 11% ;角膜内皮细胞损失率 级核为 8.2 % , 级核为 11% , 级核为 16 .6 % ;术后角膜内皮水肿混浊的发生率 级核为 0 , 级核为 9.6 % , 级核为 46 .7%。结论 细分核、高负压及高流量抽吸技术可大幅缩短超声时间和减少实际超声能量 ,显著减少了角膜内皮细胞的损失 ,降低了术后角膜内皮水肿混浊的程度和发生率 ,是一种安全、高效、适用性较广的手术技术。
Objective By improving the surgical technique of the phaco to reduce the phaco time and actual phaco power,and decrease the ultrasonic damage to the corneal endothelium,thus,the efficiency and safety of the phaco may be increased.Methods The technique of subdivision nucleus,high vacuum and high flow rate and the Stop Chop technique are used in the phaco in 600 eyes(574 cases) of senile cataract with variable nuclear density Ⅱ to Ⅳ.The phaco time,the actual phaco power,the corneal endothelial cell count (before and 1 week after operation),and the degree and rate of corneal edema and opacifiaction after operation are analysed between two techniques.Results Compared with the Stop Chop technique,the technique of subdivision nucleus,high vacuum and high flow rate is more efficient,The phaco time makes a 33% reduction in Ⅱ nucleus,30% in Ⅲ nucleus,33% in Ⅳ nucleus.The actual phaco power makes a 21% reduction in Ⅱ nucleus,20% in Ⅲ nucleus,11% in Ⅳ nucleus.The loss of the corneal endothelial cell in Ⅱ nucleus was 8.2%,in Ⅲ nucleus was 11%,in Ⅳ nucleus was 16.6%.The rate of corneal edema and opacification after operation in Ⅱ nucleus was 0,in Ⅲ nucleus was 9.6%,in Ⅳ nucleus was 46.7%.Conclusion The technique of subdivision nucleus,high vacuum and high flow rate is a safe,efficient surgical technique,and there is wide applicability.Using this technique,the phaco time and actual phaco power may be reduced considerably,and the loss of corneal endothelial cell may be decreased.
出处
《临床眼科杂志》
2001年第4期267-270,共4页
Journal of Clinical Ophthalmology
关键词
细分核
白内障
超声乳化吸除术
角膜内皮
损伤
Subdivision nucleus Cataract Phacoemulsification Corneal endothelium Damage
