Kim Eung Kweon, Cristol Stephen M, Kang Shin J, Edelhauser Henry F, Yeon Dong-Soo, Lee Jae Bum
Institute of Vision Research, Department of Ophthalmology, Yonsei University, Seoul, South Korea.
J Cataract Refract Surg. 2002 Mar;28(3):531-7. doi: 10.1016/s0886-3350(01)01155-5.
To investigate the conditions under which bubbles form during phacoemulsification.
Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
In the first part of the study, the partial pressure of oxygen (pO(2)) was used as a surrogate measure for the partial pressure of air. Irrigation solutions packaged in glass and plastic containers were studied. A directly vented glass bottle was also tested. The pO(2) of the various irrigation solutions was measured as the containers were emptied. In the second part, phacoemulsification procedures were performed in rabbit eyes with different power settings and different irrigation solutions. Intracameral bubble formation during the procedure was recorded. Following the phacoemulsification procedures, the corneas were stained for F-actin and examined for endothelial injury.
The initial pO(2) in irrigation solutions packaged in glass bottles was about half that at atmospheric levels; in solutions packaged in plastic, it was at atmospheric levels. As irrigation solutions were drained from the container, the pO(2) of the solution tended to rise toward atmospheric levels. The rate of pO(2) increase was markedly reduced by using a directly vented glass bottle. In the phacoemulsification procedures, bubble formation was most likely to occur with higher pO(2) and higher power settings. Observation of bubbles by the surgeon was highly correlated with endothelial damage.
Keeping the pO(2) low reduced the risk of endothelial damage, especially at higher phacoemulsification powers. The packaging of irrigation solutions was the most important factor in controlling the initial pO(2) of the solution. The pO(2) can be minimized throughout a phacoemulsification procedure by using a directly vented glass bottle.
研究超声乳化过程中气泡形成的条件。
韩国首尔延世大学医学院眼科。
在研究的第一部分，用氧分压（pO₂）作为空气分压的替代测量指标。对包装在玻璃和塑料容器中的冲洗液进行研究。还测试了一个直接通气的玻璃瓶。在容器排空时测量各种冲洗液的pO₂。在第二部分，对兔眼进行不同功率设置和不同冲洗液的超声乳化手术。记录手术过程中前房内气泡的形成情况。超声乳化手术后，对角膜进行F-肌动蛋白染色并检查内皮损伤情况。
包装在玻璃瓶中的冲洗液初始pO₂约为大气水平的一半；包装在塑料瓶中的冲洗液初始pO₂处于大气水平。随着冲洗液从容器中排出，溶液的pO₂趋于上升至大气水平。使用直接通气的玻璃瓶可显著降低pO₂的上升速率。在超声乳化手术中，较高的pO₂和较高的功率设置最容易导致气泡形成。外科医生观察到的气泡与内皮损伤高度相关。
保持低pO₂可降低内皮损伤风险，尤其是在较高的超声乳化功率下。冲洗液的包装是控制溶液初始pO₂的最重要因素。通过使用直接通气的玻璃瓶，在整个超声乳化手术过程中pO₂可降至最低。
