分核器劈核在白内障超声乳化术中的应用

Mechanical chopping versus phaco chopping of nuclear in cataract phacoemulsification

目的在白内障超声乳化中采用一种新型劈核方法-分核器机械劈核代替常规超声劈核,以此降低术中超声能量使用、缩短超声时间和减少灌注液的使用,从而达到保护角膜内皮细胞和降低手术并发症的目的。方法采用分核器机械劈核(实验组)与常规超声劈核(对照组)进行对比。各组选择病例100例(Ⅱ级核50例,Ⅲ级核50例),记录手术中使用超声能量和超声时间进行比较,观察术后第2天角膜内皮细胞和角膜基质细胞形态改变。结果实验组和对照组比较:(1)实验组超声时间平均每例降低9.04 s,有显著差异(P=0.009);(2)实验组超声能量平均每例降低1.74,有显著差异(P=0.001);(3)实验组术后第2天角膜内皮细胞和基质细胞形态改变明显好于对照组。结论使用分核器机械劈核代替目前的超声劈核技术,操作更简单,可以明显减少超声对角膜内皮细胞的损伤,降低手术并发症,达到白内障超声乳化手术微创目的。

Objective In order to minimize the ultrasonic energy and duration in phacoemulsification , to protect corneal endothelium , and to reduce complications of cataract surgeries , we compared mechanical chopping with phaco chopping of the nuclear in cataract surgeries .Methods Our patients were divided into two groups to receive either me-chanical nuclear chopping （group I, n=100） or ultrasonic chopping （group II, n=100） in cataract phacoemulsification. We compared energy and duration needed during surgery and postoperative endothelium morphology between the two groups.Results Both energy and time that are needed in the surgery was significantly less in patients who received me -chanical nuclear chopping .Postoperative endothelium morphology was also better in patients who received mechanical nu -clear chopping .Conclusion Mechanical nuclear chopping is a safer alternative for phaco chopping in cataract surgery .It is easier to perform , and has less adverse effects on corneal endothelium .