爆破模式与脉冲模式在白内障超声乳化术中的应用比较

Comparison between burst and pulse mode in cataract phacoemulsification

目的探讨爆破超声能量模式在超声乳化白内障吸除术中的作用。方法将165眼白内障患者随机分为脉冲及爆破2组,行颞侧透明角膜隧道切口,分别采用脉冲及爆破2种不同超声能量模式行超声乳化白内障吸除人工晶状体植入术,记录并比较2组术中所用的实际超声能量、有效超声时间及累积复合能量(实际超声能量与有效超声时间的乘积),检查术后视力、角膜水肿程度,并观察手术并发症的发生情况。结果爆破组晶状体核硬度的有效超声时间分别为:≤Ⅱ级0 min、Ⅲ级(0.12±0.02)min、Ⅳ级(0.68±0.12)min,实际超声能量及累积复合能量参数均明显低于脉冲组(P<0.001);爆破组术后角膜水肿程度均明显轻于脉冲组,(P<0.05)。结论爆破超声能量模式可明显缩短超声乳化白内障吸除术的有效超声时间,降低总体超声能量,从而减轻眼内组织损伤并提高手术疗效。

Objective It is to approach the effect of phacoemulsification by using burst mode. Methods 165 eyes were randomly assigned to the burst mode group and the pulse mode group. A temporal clear corneal incision was performed and various phaco modes were used in each group. The actual power（AP）, the effective phaco time （EPT）, accumulated energy, the best corrected visual acuity, corneal edema on the first day after operation and other complications were recorded. Results The effective phaco time of the burst mode group was 0 min for grade Ⅱ nucleus, （0.12 ± 0.02） min for grade Ⅲ nucleus and （0.68 ± 0.12） min for grade IV nucleus. And the parameter of AP and accumulated energy of burst mode group was significantly lower than that of pulse mode group （P 〈 0.01 ）, corneal edema on the first day after treatment of burst mode group was significantly lighter than that of pulse mode group （ P 〈 0.05 ）. Conclusion The burst mode phaco power reduces significantly the EPT and the amount of ultrasound energy, well diminished injury to surrounding ocular structures and elevate the operation effect.