超声乳化蚀刻翘起翻转法和拦截劈裂法的对照研究

Contrast study of turn technique and chop technique in phacoemulsification

目的 探讨超声乳化碎核方式——蚀刻翘起翻转法和拦截劈裂法各自的临床优越性。方法 超声乳化手术36 5眼 ,其中 85眼采用蚀刻翘起翻转法 ,2 80眼采用拦截劈裂法碎核 ,并分析 2种方法的结果。结果 (1)碎核时间 :同对 3级核 ,翻转法平均为 81.2 6 s,拦截法平均为 40 .71s;(2 )术后 1wk视力 :翻转法的 85眼中 ,视力≥ 0 .5者 76眼(89.4% ) ,0 .2～ 0 .5者 7眼 (8.2 % ) ,视力≤ 0 .2者 2眼(2 .4% ) ;拦截法的 2 80眼中 ,视力≥ 0 .5者 2 5 3眼 (90 .4% ) ,0 .2～ 0 .5者 2 1眼 (7.5 % ) ,视力≤ 0 .2者 6眼 (2 .1% ) ;(3)术后角膜内皮反应 :1wk后仍有中心内皮皱褶者翻转法 4眼(4 .7% ) ,拦截法 7眼 (2 .5 % )。结论 前者相对手术难度小、碎核时间相对较长 ;后者的手术时间短 ,适于硬核 ,且技术更趋于成熟。二者术后视力及小角膜损伤无显著性差异。

Objective To explore the clinical superiority of two kinds of chopping nucleus methods in phacoemulsification——etch and turn technique, stop and chop technique.Methods Three hundred and sixty five eyes were performed with phacoemulsification, among which 85 eyes were performed with turn technique and 280 eyes were performed with chop technique.The results of the two kinds of chopping nucleus were analyzed.Results (1)Time of chopping nucleus:time of turn technique averaged 81.26 seconds while chop technique averaged 40.71 seconds; (2)Visual acuity in the first week after operation:turn technique:vision of 76 of 85 eyes were 0.5 of better, 7 eyes were 0.2~0.5(8.2%) and 2 eyes were 0.2 or worse; chop technique: vision of 253 of 280 eyes were 0.5 or better (90.4%), 21 eyes were 0.2~0.5(7.5%) and 6 eyes were 0.2 or worse (2.1%);(3)Reaction of corneal endothelial cells after the operation: central endothelium rugosity appeared in 4 eyes (4.7%) with turn techinque and in 7 eyes (2.5%) with chop technique. Conclusion The operation of the former is less difficult and the chopping nucleus time is longer. The time of the operation on the latter is shorter and it is appriate for hard nucleus and should be applied and spreaded. There are no marked differences as for the vision after the operation and the microcorneal injury between them.