白内障超声乳化摘出术三种方法的比较

Comparison on three methods of phacoemulsiifcation

目的：评估和比较白内障超声乳化摘出术的常规爆破、扭动爆破及扭动持续模式的临床疗效。方法：选取晶状体核硬度芋~郁级的白内障159例159眼,随机分为常规爆破组41例41眼、扭动爆破组63例63眼及扭动持续组55例55眼,分别采用常规爆破、扭动爆破及扭动持续模式的白内障超声乳化摘出联合人工晶状体植入术,比较三组术前及术后2wk角膜内皮细胞计数、角膜内皮细胞损失率、累积能量复合参数（cumulativedissipatedenergy,CDE）以及最佳矫正视力的情况。结果：术后2wk,芋级核和郁级核常规爆破组的CDE均明显少于扭动爆破组和扭动持续组（P〈0.05）;角膜内皮细胞损失率常规爆破组明显大于其余两组,差异有统计学意义（P〈0.05）;平均最佳矫正视力：三组组间比较均无显著差异（P〉0.05）。结论：常规爆破模式、扭动爆破模式及扭动持续模式均能有效、安全的实施白内障超声乳化摘出手术,视力提高无明显差异,但相比较而言,扭动爆破及扭动持续模式效率更高,对角膜内皮的保护也更好。

Department of Ophthalmology, the First People＇s Hospital of Nantong, Nantong 226000, Jiangsu Province, China; ZDepartment of Ophthalmology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 320100, Jiangsu Province, China AIM： To evaluate the effects mode and ozil continue mode cataract extraction. of burst mode, ozil burst n phacoemulsification for METHODS ：Totally 159 eyes with age related cataract in Ⅲ - Ⅳ nuclear subgroup treated by phacoemulsification were divided into burst mode group （41 eyes）, ozil burst mode group （63 eyes） and ozil continue mode （55 eyes）. The number of corneal edema cells before the operation and two weeks after the operation, and the loss rate of corneal edema cells, cumulative dissipated energy （CDE） in phacoemulsification and the best- corrected visual acuity on the second week were compared among the three groups. RESULTS：Two weeks after operation, the CDE in burst mode for Ill nuclear subgroup and IV nuclear subgroup were obviously lower than the result of ozil burst mode and that of ozil continue mode （P〈 0. 05）, and the differences were statistically significant. Endothelial cell loss rate postoperatively for Ⅲ nuclear subgroup was higher in the burst mode than that in the ozil burst mode and that in the ozil continue mode. So does that of the IV nuclear subgroup. Best-corrected visual acuity on the second week after treatment of burst mode, ozil burst mode and ozil continue mode for both Ⅲ nuclear subgroup and IV nuclear subgroup had no statistically significant differences among the three groups （P〉0.05）. CONCLUSION： Burst mode, ozil burst mode and ozil continue mode are all safe and effective for the phacoemulsification on cataract. The efficiency of cataract surgery with ozil burst mode and ozil continue mode are better than that with burst mode, and they can protect endothelial cell better.