白内障超声乳化吸除术中混合超声模式的应用研究

Application of a hybrid ultrasound mode in phacoemulsification cataract surgery

目的探讨混合超声动力模式应用于白内障超声乳化吸除术的安全性及有效性。方法将年龄相关性白内障,随机分为3组:往复超声模式(传统组)、扭动+往复模式(混合组)、单纯扭动模式(扭动组)行白内障超声乳化术。记录并比较超声时间(UST)、超声能量(CDE)、术后角膜水肿程度、术后最佳矫正视力、角膜内皮数、角膜内皮细胞丢失率。结果UST、CDE、术后1d、7d角膜水肿程度、术后1d、7d最佳矫正视力、术后7d、1个月角膜内皮细胞数和角膜内皮细胞丢失率比较:3组间差异有统计学意义(P<0.05)。混合组与扭动组差异无统计学意义(P>0.05)。结论混合超声模式与扭动模式相仿,可减少术中超声能量和超声时间,提高乳化效率,明显减轻患者角膜内皮的损伤,较传统超声模式更为安全有效,在减少管道阻塞和减轻前房雾化方面优于单纯扭动模式。

Objective To study the efficiency and safety of a hybrid ultrasound power mode. Methods The age-related cataracts were randomly divided into reciprocating the phacoemulsification mode （conventional ultrasound mode group ）and the torsional combined with reciprocating phacoemulsification mode （hybrid mode group） and the torsional mode group. The intraoperative data of Ultrasound Time （UST） and Cumulative Dissipated Energy （CDE） were measured and compared. Postoperative outcome measures including corneal clarity, the best corrected visual acuity （BCVA）, central endothelial corneal cell counts, and the corneal endothelial ceils loss rate were also measured and compared. Results The differences among the three groups in the UST 、 CDE 、 degree of postoperative corneal edema、 the best-corrected visual acuity （BCVA） of postoperative 1 day and 7 days, corneal endothelial counts and corneal endothelial of postoperative 7 days and 30 days showed significant differences （ P 〈 0.05 ）. There were no differences between the hybrid mode group and the torsional mode group （ P 〉 0.05 ）. Conclusion The hybrid ultrasound mode is similar to the torsional mode, which not only can reduce intra-operative ultrasound energy and ultrasonic time, but also can improve the emulsification efficiency and significantly reduce intraocular trauma. The hybrid ultrasound mode is safer and more effective than the conventional ultrasound mode, which is superior to the torsional mode in reducing blocked pipes and mitigating the anterior chamber pipe fog.