白星ICE技术在超声乳化白内障摘出术中的临床应用

The application of WhiteStar ICE system in phacoemulsification

目的探讨白星增加控制与效率(ICE)技术在超声乳化白内障摘出术中应用的临床效果。方法将76例(92眼)白内障患者分为白星组和ICE白星组,分别采用白星技术及白星ICE技术能量释放模式行超声乳化白内障摘出+人工晶状体植入术。记录并比较两组术中所用的超声能量、有效超声乳化时间,检查术后视力、角膜水肿程度及角膜内皮细胞密度,并观察手术并发症的发生情况。结果白星ICE组晶状体核硬度Ⅲ级以上患者有效超声乳化时间、实际超声能量均明显低于白星组,差异均有统计学意义(P<0.05)。白星ICE组术后1个月角膜内皮丢失率11.4%±4.9%明显低于白星组14.6%±5.7%,差异有统计学意义(P<0.05)。结论白星ICE技术能量模式可使核硬度Ⅲ级以上白内障超声乳化摘出术的有效超声乳化时间及总超声能量降低,从而减轻对角膜内皮的损伤,提高手术疗效,值得临床推广使用。

Objective WhiteStar ICE technique is a new way derived from WhiteStar technique and has been applied in phacoemulsification. We tried to compare and evaluate the clinical outcome of phacoemulsification using WhiteStar ICE system. Methods Ninety-two eyes from 76 patients with age-related cataract were included in this study, All patients having phacoemulsification with the Sovereign were assigned to WhiteStar group or WhiteStar ICE group. The effective phaco time （EPT） and the actual power was recorded during the operation. The visual acuity, corneal edema and loss of corneal endothelial cells were compared between these two groups. Results The mean EPT in WhiteStar ICE group was （4.95 ± 2.48 ） s and the actual power was （ 11.71 ± 3.33 ）% , and those in W hiteStar group was （6.19 ± 1.86 ）s and （13.92 ±2.95 ）% ,indicating a significant difference in the eyes with HI grade of lens nuclear between two groups （P 〈 0.05）. In the eyes with 〉 IV grade of lens nuclear, the mean EPT in WhiteStar ICE group was （ 8.72 ± 1.54） s and the actual power was （ 16.71 ± 2.02） % , and those in WhiteStar group was （ 10. 77 ± 1.18 ） s and （ 18.66± 1.79） % , showing a statistically shorter EPT （ P 〈 0. 01 ） and the lower mean actual power （P 〈 0.05） in WhiteStar ICE group compared with WhiteStar group. The mean endothelial cell loss rate in WhiteStar ICE group （ 11.40±4.98 ） % was significantly less than WhiteStar group （ 14.64 ± 5.76 ） % 1 month after surgery （ P 〈 0.01 ）. No evident difference was found in the visual acuity （X^2 = 0. 154 ,P = 0. 926） and corneal endothelial edema after operation （X^2 = 1. 151 ,P = 0. 283） between these two groups. Conclusion The WhiteStar ICE system increase efficiency of ultrasound power and decrease the loss of endothelial cells.