[1]孙丽丽,季拓,齐丽丽,等.微脉冲超声能量模式在白内障超声乳化吸出术中的应用效果[J].眼科新进展,2019,39(12):1153-1156.[doi:10.13389/j.cnki.rao.2019.0265]
　SUN Li-Li,JI Tuo,QI Li-Li,et al.Application effect of micro-pulse ultrasonic energy mode in phacoemulsification[J].Recent Advances in Ophthalmology,2019,39(12):1153-1156.[doi:10.13389/j.cnki.rao.2019.0265]
点击复制

微脉冲超声能量模式在白内障超声乳化吸出术中的应用效果/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年12期
页码:
1153-1156
栏目:
应用研究
出版日期:
2019-12-05

文章信息/Info

Title:
Application effect of micro-pulse ultrasonic energy mode in phacoemulsification
作者:
孙丽丽; 季拓; 齐丽丽; 赵佳钰; 魏达亨; 吴佳妮; 彭荟竹
121000　辽宁省锦州市，锦州医科大学附属第三医院眼科（孙丽丽，齐丽丽，赵佳钰，魏达亨）；121000　辽宁省锦州市，锦州医科大学科技处（季拓）；121000　辽宁省锦州市，锦州医科大学研究生学院（吴佳妮，彭荟竹）
Author(s):
SUN Li-Li; JI Tuo; QI Li-Li; ZHAO Jia-Yu; WEI Da-Heng; WU Jia-Ni; PENG Hui-Zhu
Department of Ophthalmology，the Third Affiliated Hospital of Jinzhou Medical University(SUN Li-Li，QI Li-Li，ZHAO Jia-Yu，WEI Da-Heng)，Jinzhou 121000，Liaoning Province，China；Department of Science and Technology，Jinzhou Medical University (JI Tuo)，Jinzhou 121000，Liaoning Province，China；Graduate School of Jinzhou Medical University(WU Jia-Ni，PENG Hui-Zhu)，Jinzhou 121000，Liaoning Province，China
关键词:
微脉冲模式; 白内障超声乳化术; 角膜内皮细胞; 最佳矫正视力
Keywords:
micro-pulse mode; phacoemulsification; corneal endothelial cell; best corrected visual acuity
分类号:
R776
DOI:
10.13389/j.cnki.rao.2019.0265
文献标志码:
A
摘要:
目的　观察微脉冲超声能量模式在白内障超声乳化吸出术中应用的临床效果。方法　选择2018年9月至2019年2月于我院就诊并行白内障超声乳化吸出联合人工晶状体植入术的患者146例（178眼）进行前瞻性随机对照研究。将患者分为2组，微脉冲模式组（A组，88眼）、脉冲模式组（B组，90眼）。再根据Emery核硬度分级标准将2组患者各分为1（Ⅱ级核，59眼）、2（Ⅲ级核，86眼）、3（Ⅳ级核，33眼）小组。记录术前视力、白内障核硬度分级；比较2组术中所用的实际超声能量（actual power，AP）、有效超声时间(effective phaco time，EPT)；术后1 d和7 d最佳矫正视力（best corrected visual acuity，BCVA）；术后1 d、7 d和30 d的中央区角膜内皮细胞密度（corneal endothelial cell density，CECD）、六角形细胞比率和术后30 d的角膜内皮细胞损失率。结果　A组和B组的AP、EPT比较：各组间比较AP均减少、EPT均缩短。A1、B1组比较差异无统计学意义(P＞0.05)；A2、B2组及A3、B3组之间比较差异均有统计学意义(均为P＜0.05)。中央区CECD、PHC比较：术后1 d、7 d、30 d分别与术前比较，差异均有统计学意义（均为P＜0.05）。中央区CECD术后不同时间点比较：A1组与B1组差异均无统计学意义（均为P＞0.05），A2组与B2组、A3组与B3组之间差异均有统计学意义（均为P＜0.05）。术后1 d、7 d A3组与B3组PHC比较差异均有统计学意义（均为P＜0.05），术后30 d各组间比较差异均无统计学意义（均为P＞0.05）。角膜内皮细胞损失率比较：术后30 d A组与B组差异有统计学意义（P＜0.05）。术后BCVA：术后1 d、7 d A组及B组比较差异有统计学意义(P＜0.05)，而术后30 d A、B组差异无统计学意义(P＞0.05)。结论　微脉冲超声能量模式可使白内障超声乳化吸出术的超声时间缩短、超声能量降低，可减少对眼内组织特别是对角膜内皮细胞的损伤，其安全性、有效性值得在临床上推广使用。
Abstract:
Objective　To evaluate the clinical effect of applying micro-pulse ultrasonic energy mode in phacoemulsification.Methods　A prospective randomized study was conducted in 146 patients (178 eyes) who underwent phacoemulsification combined with intraocular lens implantation from September，2018 to February，2019.The patients were registered into two groups：micro-pulse mode group (Group A，88 eyes) and pulse mode group (Group B，90 eyes).Each group was divided into 3 subgroups according to Emery nuclear hardness grading standard：subgroup 1（Class Ⅱ nuclear，59 eyes)，subgroup 2（Class Ⅲ nuclear，86 eyes) and subgroup 3 (Class Ⅳ nuclear，33 eyes).Preoperative measurements included visual acuity and cataract nuclear hardness grade；intraoperative measurements included actual power (AP) and effective phaco time (EPT)；postoperative measurements included best correct visual acuity (BCVA) 1 day and 7 days after operation；postoperative 1-day，7-day and 30-day central corneal endothelial cell density (CECD)，percentage of hexagon cells (PHC) and postoperative 30-day loss of corneal endothelial cells.Results　Comparison of AP and EPT between Group A and Group B：AP was reduced and EPT was shortened in comparison between groups.There was no statistically significant difference between GroupA1 and Group B1 (all P>0.05)；the differences between Group A2，Group B2，Group A3 and Group B3 were statistically significant (all P<0.05).Comparison of CECD and PHC in central region：postoperative 1-day，7-day and 30-day after surgery were compared with those before surgery，respectively，and the differences were statistically significant (all P<0.05).Comparison of CECD at different time after surgery：there was no statistically significant difference between Group A1 and Group B1 (all P>0.05)，but there were statistically significant differences between Group A2 and GroupB2，GroupA3 and GroupB3 (all P<0.05)；differences in postoperative 1-day，7-day PHC of GroupA3 and GroupB3 are statistically significant (all P<0.05)，but difference in postoperative 30-day PHC between groups were not statistically significant (all P>0.05).Comparison of the loss rate of corneal endothelial cells：the loss rate of corneal endothelial cells 30 days after surgery was statistically significant between Group A and Group B (P<0.05).Postoperative BCVA：there was a statistically significant difference between the two groups 1 day and 7 days after surgery (P<0.05)，while there was no statistically significant difference between the two groups 30 days after surgery (P>0.05).Conclusion　Micro-pulse ultrasonic energy mode can shorten the ultrasonic time，reduce the ultrasonic energy and reduce the damage to the intraocular tissues.Therefore its safety and effectiveness are worthy of clinical application.

参考文献/References:

［1］　YU X Y，WANG D D，CHANG P J，XIE J L，LI Z L，LIAN H，et al.The effect of three intraoperative corneal wetting solutions on dry eye after cataract surgery［J］.Chin J Optom Ophthalmol Vis Sci，2017，19(4)：236-242.
俞晓宇，王丹丹，常平骏，谢佳璐，李璋亮，廉恒，等.角膜保护剂对白内障术后干眼的影响［J］.中华眼视光学与视觉科学杂志，2017，19(4)：236-242.
［2］　LI N，WANG J F，PU J L，LI J.A comparative study of the effects of phacoemulsification and small incision cataract extraction on corneal endothelial cells［J］.Chin General Medicine，2017，15(10)：1666-1668，1703.
李宁，王剑锋，卜京丽，李娟.超声乳化白内障摘除术与小切口白内障摘除术对角膜内皮细胞影响的对比研究［J］.中华全科医学，2017，15(10)：1666-1668，1703.
［3］　PARK S，KANG S，LEE E，KWAK J，PARK E，LIM J，et al.Ultrasound biomicroscopic study of the effects of topical latanoprost on the anterior segment and ciliary body thickness in dogs［J］.Vet Ophthalmol，2016，19(6)：498-503.
［4］　XIE C，FANG F，FANG Y.Clinical analysis of the correlation between type 2 diabetes mellitus and dry eye after cataract surgery［J］.Rec Adv Ophthalmol，2017，37 (8)：773-775.
谢驰，方芳，方严.2 型糖尿病与白内障术后干眼相关性的临床分析［J］.眼科新进展，2017，37(8)：773-775.
［5］　YANG J J，XU T J.A novel phacoemulsification needle with scissor-like motion end effector for reducing heat generation at cornea incision［J］.Sensors Actuat A-Phys，2019，［Epub ahead of print］.
［6］　ZHANG C Y，DONG W L，GUO L T，SHI W D，WANG S，XU X M.Effect of corneal protectant on ocular surface after phacoemulsification in type 2 diabetic patients［J］.Int Eye Sci，2019，19 (4)：555-558.
张春妍，董微丽，郭立涛，石雯迪，王森，许雪妹.角膜保护剂对2型糖尿病患者白内障超声乳化术后眼表的影响［J］.国际眼科杂志，2019，19(4)：555-558.
［7］　ROBERTS H W，WAGH V K，SULLIVAN D L，DETESAN D L，HEEMRAZ B S，SPARROW J M，et al.A randomized controlled trial comparing emtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery［J］.J Cataract Refract Surg，2019，45(1)：11-20.
［8］　PERONE J，BOICHE M，LHUILLIER L，AMELOOT F，PREMY S，JEANCOLAS A L，et al.Correlation between postoperative central corneal thickness and endothelial damage after cataract surgery by phacoemulsification［J］.Cornea，2018，37(5)：587-588.
［9］　WANG J J，LU Y P，XU L L，YE Q Q.Clinical study of small incision non-phacoemulsification and phacoemulsification for age-related cataract［J］.Zhejiang Med，2018，40(12)：1361-1364.
王俊杰，卢勇攀，许伶伶，叶倩倩.小切口非超声乳化吸除术和超声乳化吸除术用于年龄相关性白内障的临床研究［J］.浙江医学，2018，40(12)：1361-1364.
［10］　MASTROPASQUA L，TOTO L，MASTROPASQUA A，VECCH-IARINO L，MASTROPASQUA R，PEDROTTI E，et al.Femtosecond laser versus manual clear corneal incision in cataract surgery［J］.J Refract Surg，2014，30(1)：27-33.
［11］　LIN H B，LI W L，ZHUO X，HE A Q.Effects of phacoemulsification with different incisions on corneal endothelium and tear film function in age-related cataract patients［J］.Int J Ophthalmol，2018，11(7)：1257-1260.
［12］　NA KS，YOO Y S，HWANG K Y，MOK J W，JOO C K.Tear osmolarity and ocular surface parameters as diagnostic markers of ocular graft-versus-host disease［J］.Am J Ophthalmol，2015，160(1)：143-149.
［13］　HE Y，LI J，ZHU J，ZHU J F，JIE Y，WANG N L，et al.The improvement of dry eye after cataract surgery by intraoperative using ophthalmic viscosurgical devices on the surface of cornea：The results of a consort-compliant randomized controlled trial［J］.Medicine，2017，96(50)：e8940.
［14］　ALSABAANI N A，ABUBAKER A，ALMALKI S.Implantable collamer lens for the correction of post-keratoplasty myopia and astigmatism［J］.Int Eye Sci，2018，18(6)：975-978.
［15］　BOWEN R C，ZHOU A X，BONDALAPATI S，LAWYER T W，SNOW K B，EVANS P R，et al.Comparative analysis of the safety and efficacy of intracameral cefuroxime，moxifloxacin and vanco-mycin at the end of cataract surgery：a meta-analysis［J］.Br J Ophthalmol，2018，102(9)：1268-1276.

相似文献/References:

[1]徐冰 董宁 肖林 褚利群 徐景美 王冰松.不同剂量曲安奈德前房注射抑制青光眼联合白内障手术后前葡萄膜炎的临床研究[J].眼科新进展,2012,32(6):000.
[2]徐冰 董宁 肖林 徐景美 褚利群 马骁.Toric人工晶状体植入术与球面人工晶状体植入联合周边角膜缘松解术矫正散光的对比研究[J].眼科新进展,2013,33(1):000.
[3]雷智.高度近视一眼白内障另一眼透明晶状体双眼手术的疗效分析[J].眼科新进展,2013,33(8):000.
[4]徐冰 褚利群 肖林 刘晶 董宁.透明角膜切口联合对侧单切口角膜缘松解术矫正散光的临床效果[J].眼科新进展,2012,32(3):000.
[5]周正申 孙静芬.白内障超声乳化术后黄斑区光学相干断层扫描观察[J].眼科新进展,2013,33(2):000.
[6]庄靖玲.白内障超声乳化联合人工晶状体植入术在治疗闭角型青光眼合并白内障患者中的应用[J].眼科新进展,2013,33(12):000.
[7]孙冰 孙思勤 温跃春 吴章友. α-1受体拮抗剂患者瞳孔直径与Phaco术中虹膜松弛综合征的关系[J].眼科新进展,2014,34(2):172.
[8]李晓鹏,焦军杰,王爽,等. 白内障超声乳化联合玻璃体切割术治疗增生性糖尿病视网膜病变[J].眼科新进展,2015,35(4):374.[doi:10.13389/j.cnki.rao.2015.0101]
　LI Xiao-Peng,JIAO Jun-Jie,WANG Shuang,et al. Cataract phacoemulsification combined with vitrectomy for proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2015,35(12):374.[doi:10.13389/j.cnki.rao.2015.0101]
[9]李璐,丁剑锋,杨炜. 青光眼滤过术后白内障患者行超声乳化联合人工晶状体植入术毕前房注射地塞米松的临床疗效[J].眼科新进展,2015,35(9):857.[doi:10.13389/j.cnki.rao.2015.0234]
　LI Lu,DING Jian-Feng,YANG Wei. Clinical research of injecting dexamethasone into anterior chamber after phacoemulsification in cataract patients following trabeculectomy of glaucoma[J].Recent Advances in Ophthalmology,2015,35(12):857.[doi:10.13389/j.cnki.rao.2015.0234]
[10]钱锦,朱炜敏,肖燕倩,等.化瘀明目饮对糖尿病患者白内障术后黄斑区的保护作用[J].眼科新进展,2016,36(2):165.[doi:10.13389/j.cnki.rao.2016.0045]
　QIAN Jin,ZHU Wei-Min,XIAO Yan-Qian,et al.Protective effects of huyumingmu decoction on macular area after phacoemulsification in diabetic patients[J].Recent Advances in Ophthalmology,2016,36(12):165.[doi:10.13389/j.cnki.rao.2016.0045]

备注/Memo

备注/Memo:
辽宁省自然科学基金资助（编号：20180550611）
更新日期/Last Update: 2019-12-17