Retrospective Analysis of the Performance of a New-Generation Dual Pump Phaco System Using Two Sizes of Phaco Tips in Cases with Different Nuclear Hardness

Purpose: To evaluate the performance of a phacoemulsification system in terms of effective (EPT) and total phaco time (TPT) using 20G and 21G phaco tips. Methods: Retrospective comparative study including 143 consecutive cataractous eyes undergoing phacoemulsification cataract surgery with the Visalis 500 device. The 20G and 21G phaco tips were used in 46 and 97 eyes, respectively. The EPT and TPT values were evaluated. Results: Median TPT was 11.25 s and 17.50 s in the 20G and 21G groups, respectively (p = 0.0011). Median EPT values were 3.15 s and 5.00 s in the 20G and 21G groups, respectively (p = 0.0032). TPT and EPT were significantly lower in 3/3+ cataract eyes compared to 4/4+ using both tips (p < 0.001). Conclusions: The Visalis 500 allows cataract surgery with reduced TPT and EPT, even in hard cataracts. The use of the 20G phaco tip provides an additional benefit in terms of reduction of phaco time.

白内障超声乳化术后前房膜形成的危险因素(英文)

目的:探讨白内障超声乳化术后前房膜形成的危险因素。方法:对1356例行白内障超声乳化+单片式PMMA人工晶体植入术患者进行前瞻性研究。假性囊膜剥脱综合症,核硬度,瞳孔大小,超声时间,实际超声时间,系统性疾病,术中并发症(囊膜撕裂,悬韧带断裂,后囊破裂伴玻璃体丢失),IOL植入位置和术后并发症(眼内压变化,粘连形成)作为膜形成的危险因素分析。结果:观察到111例患者(8.1%)术后出现伴有膜形成的纤维素性前葡萄膜炎。膜形成平均时间是术后第2d(术后第1～7d),膜存在持续时间平均为5.2d(1～48d)。在膜形成病例中,+4级核病例占45%,而在无膜形成病例中仅为13.5%,差异具有显著统计学意义(P<0.05)。在膜形成组,平均超声时间为2.4min,平均实际超声时间为32.8s,而无膜形成组分别为1.8min和22.1s。这两项参数在膜形成组均明显较长(P<0.05)。在膜形成组中,出现后囊破裂伴玻璃体丢失和IOL睫状沟植入者占33%,而无膜形成组为11%(P<0.05)。其他危险因素在膜形成组和无膜形成组中的比较无统计学意义。在术后第1d和第7d,平均最佳矫正视力(Snellen视力表)在膜形成组分别为0.2和0.4,无膜形成组为0.4和0.6(P<0.05)。但术后3mo,平均最佳矫正视力在膜形成组和无膜形成组中结果相似(分别为0.8和0.9)。结论:晶状体核硬度较高,较长超声时间和实际超声时间,术中后囊破裂是术后前房纤维膜形成的明显相关性危险因素。