超声乳化爆破模式在白内障手术中的应用

Application of phacoemulsification blasting mode in cataract surgery

目的探讨超声乳化爆破模式在白内障术中应用及对角膜内皮细胞影响。方法选取2018年8月至2020年1月合肥市第二人民医院年龄相关性白内障79例(83眼),其中42眼采用爆破模式行白内障超声乳化术(爆破组)。另41眼作为对照组采用连续模式行白内障超声乳化术(连续组)。术中连续组最大能量50%,最大负压240 mmHg,流量26 mL/min;爆破组最大能量50%,最大负压300 mmHg,流量30 mL/min。观察术中有效超声乳化时间(EPT)、平均超声乳化功率(AVE),比较两组术前、术后1 d、1周、1个月角膜内皮细胞密度、六角形细胞比例、变异系数及中央角膜厚度等。结果爆破组EPT(12.31±8.30)s、AVE(10.00±6.81)%均低于连续组EPT(18.51±9.30)s、AVE(15.01±7.90)%,差异有统计学意义(P<0.05)。术后1天、1周爆破组角膜内皮细胞密度、六角形细胞比例均高于连续组、变异系数低于连续组,差异有统计学意义(P<0.05)。结论超声乳化爆破模式能提高超声乳化效率,减轻角膜内皮细胞损伤。

Objective To explore the application of blast phacoemulsification in cataract surgery and its effects on corneal endothelium.Methods Seventy-nine cases(83 eyes)of age-related cataracts in the Second People’s Hospital of Hefei from August 2018 to January 2020 were selected.Among them,the blasting mode for cataract phacoemulsification was applied in 42 eyes(the blasting group),while the other 41 eyes used continuous mode for cataract phacoemulsification(the continuous group).In the continuous group,the maximum energy was 50%,the maximum negative pressure was 240 mmHg,and the flow rate was 26 mL/min;in the blasting group,the maximum energy was 50%,the maximum negative pressure was 300 mmHg,and the flow rate was 30 mL/min.The effective phacoemulsification time(EPT)and average phacoemulsification power(AVE)were observed during the surgery.The corneal endothelial cell density,hexagonal cell ratio,coefficient of variation,central corneal thickness and other parameters were checked and statistically analyzed before the surgery,one day,one week and one month after the surgery.Results EPT[(12.31±8.30)s vs.(18.51±9.30)s]and AVE[(10.00±6.81)%vs.(15.01±7.90)%]in the blasting group were decreased than those in the continuous group,and the difference was statistically significant(P<0.05).The density of the corneal endothelial cell,the ratio of hexagonal cells in the blasting group were higher than those in the continuous group on the day after the surgery and one week later,and the coefficient of variation was lower than that in the continuous group.The difference was statistically significant(P<0.05).Conclusion The phacoemulsification blasting mode can improve the efficiency of phacoemulsification and reduce the damage of corneal endothelial cell.