改良垂直刃超薄劈核刀与超声乳化劈核对白内障超声乳化的影响

Effect of self-made vertical-blade ultra-thin nuclear chopper and traditional stop-and-chopin on cataract phacoemulsification

目的:探讨改良垂直刃超薄劈核刀与传统拦截劈核对白内障超声乳化效果的影响。方法:按使用手术器械不同,将110例接受白内障劈核手术的患者分为A组(n=55,56眼)和B组(n=55,60眼)。所有患者均接受白内障超声乳化手术治疗,A组患眼使用改良垂直刃超薄劈核刀和劈核钩进行预劈核,B组患眼使用超声乳化拦截劈核技术进行劈核。比较两组患眼劈核成功率、超声乳化时间(UST)、超声乳化消耗能量(CDE)。分析手术前和术后3个月时最佳矫正视力(BCVA)、角膜内皮细胞(CEC)情况(计数、丢失率)。比较术后1个月内两组患眼并发症发生率(角膜内皮水肿、囊破裂、晶体脱位)。结果:A组患眼劈核成功率高于B组(P<0.05),但UST和CDE均低于B组(P<0.05)。A组术后囊破裂、晶体脱位发生率低于B组,术后3个月两组患者患眼BCVA较治疗前均升高,且A组高于B组(P<0.05);两组患者患眼CEC计数低于术前,且A组患眼高于B组(P<0.05),A组患眼CEC丢失率低于B组(P<0.05)。术后1个月内A组患眼角膜内皮水肿、囊破裂、晶体脱位发生率均低于B组(P<0.05)。结论:改良垂直刃超薄劈核刀用于白内障超声乳化手术劈核成功率较高,可明显减少超声乳化时间和能量,降低角膜内皮细胞损伤和并发症发生风险。

Objective:To investigate the effects of self-made vertical-blade ultra-thin nuclear chopper and traditional stop-and-chopin on cataract phacoemulsification.Methods:A total of 110 cases of cataract splitting surgery patients were selected and divided into group A(55 cases 56 eyes)and group B(55 cases 60 eyes)according to the use of surgical instruments.All patients received phacoemulsification surgery with nucleus pre-chopping,and group A was given Improved ultra-thin split core knife with vertical blade and nucleus chopping hook for nucleus pre-chopping,and group B applied traditionalstop-and-chop tool for nucleus chopping.The success rate of nucleus chopping of affected eyes,Ultrasonic time(UST),and Color Doppler Energy(CDE)were compared between the two groups.The best corrected visual acuity(BCVA)and corneal endothelial cell(CEC)status(count,loss rate)were compared before surgery and at 3 months after surgery.The incidence rates of complications(corneal endothelial edema,capsulerupture,lens dislocation)were compared between the two groups within 1 month after surgery.Results:The success rate of nucleus chopping of affected eyes in group A was significantly higher than that in group B(P<0.05),while the UST and CDE were significantly lower than those in group B(P<0.05).The incidence of capsular rupture and lens dislocation in group A was lower than that in group B.At 3 months after surgery,the BCVA of affected eyes of the two groups was significantly higher than that before treatment,and the BCVA of group A was higher than that of group B at the same time point(P<0.05).The CEC count of the two groups was significantly lower than that before surgery,and the CEC count of group A was higher than that of group B(P<0.05),and the loss rate of CEC of affected eyes in group A was significantly lower than that in group B(P<0.05).The incidence rates of corneal endothelial edema,capsulerupture and lens dislocation in group A were significantly lower than those in group B at the same time point(P<0.05).Conclusion:Improved ultra-thin split core knife with vertical blade has a high success rate of nucleus chopping in phacoemulsification,and can significantly reduce the time and energy of phacoemulsification,and lower the risk of corneal endothelial cell damage and complications.