硬核白内障超声乳化吸出术中扭动模式与爆破模式的效果比较

The contrast effects of phacoemulsificafion on hard nuclei with torsional mode and burst mode,

目的研究扭动模式和爆破模式在硬核白内障超声乳化吸出术中的对比效果。方法Ⅳ级硬核（Emery分级）老年性白内障超声乳化吸出术51例（65眼），随机分为扭动模式组和爆破模式组。记录两组术中累积释放能量（CDE）、平均超声时间（UST）、术后1d、7d角膜水肿程度、术后1d、7d、30d最佳矫正视力（BCVA）及术后3个月角膜内皮细胞丢失情况。结果扭动模式组较爆破模式组术中CDE少（P〈0．05），但两组间UST比较差异无统计学意义（P〉0．05）。术后1d扭动模式组角膜水肿程度较轻，差异有统计学意义（X^2=8．620，P〈0．05），但术后7d两组角膜水肿程度差异无统计学意义（X^2=0．955，P〉0．05）。术后1d扭动模式组BCVA优于爆破组，差异有统计学意义（X^2=4．975，P〈0．05），但术后7及30天两组BCVA差异无统计学意义（P〉0．05）。术后3个月角膜内皮细胞计数丢失数，扭动模式组较爆破模式组低，两组差异有统计学意义（t=4．317，P〈0．05）。结论在硬核白内障超声乳化吸出术，扭动模式较爆破模式对眼内组织损伤更小，更高效和安全，有助于更快恢复视力。

Objective To investigate the contrast effects of phacoemulsification on hard nuclei with torsional mode and burst mode. Methods Fifty one cataract cases（65 eyes） with nuclei density grade of IV （ according to the Emery classification） were comprised in this study. All cases were randomly divided into two groups： torsional group and burst group. The ultrasound time（UST） and cumulative dissipated energy（ CDE）, corneal edema, best corrected visual acuity（BCVA） and corneal endothelial cell loss were recorded. Results The mean CDE in torsional group was statistically significantly lower than that in burst group （ P 〈 0.05 ）. The difference between the two groups was not statistically significant （P 〈 0.05 ）. Cornea edema on the first postoperative day in torsional group was statistically significantly better than that in burst group （X^2 = 8. 620, P 〈 O. 05） ,but on the seventh postoperative day, there were no statistically significant differences between the two groups（X^2 =0. 955,P 〉0. 05）. The average best corrected visual acuity in torsional group was statistically significantly better than that in burst group on the first postoperative day （X^2 = 4. 975, P 〈 0.05 ）, but on the seventh and thirtieth postoperative day, there were no statistically significant differences between the two groups （ P 〉 0.05 ）. The mean endothelial cell loss in torsional group was significantly less than that in burst group on the third postoperative month （t = 4. 317 ,P 〈 0.05 ）. Conclusion The intraoperative damage to oc ular structures may be minimized and the level as well as the rapidily of visual rehabilitation may be maximized with the torisional mode during phacoemulsification on hard muclei of cataract surgery.