Floyd Michael, Valentine Jeremy, Coombs Jamie, Olson Randall J
Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA.
J Cataract Refract Surg. 2006 Jul;32(7):1222-6. doi: 10.1016/j.jcrs.2006.01.107.
To determine the thermal features of the Legacy (Alcon) and Sovereign (Advanced Medical Optics) phacoemulsification machines in a cadaver eye and with 7 ophthalmic viscosurgical devices (OVDs).
In situ and in vitro study.
Temperature without occlusion was recorded at the sleeve placed in the wound of a cadaver eye, and temperature over baseline was determined after 60 seconds. The result was then compared with the results in a previous study that used balanced salt solution (BSS) in artificial chambers. In the second portion of the experiment, with irrigation and aspiration lines occluded, temperature was recorded at the sleeve placed in an artificial chamber filled with sodium hyaluronate 2.3% (Healon5), sodium hyaluronate 1.4% (Healon GV), sodium hyaluronate 1.0% (Healon), sodium hyaluronate 1.6% (Amvisc Plus), sodium hyaluronate 1.0% (Provisc), sodium hyaluronate 3.0%-chondroitin sulfate 4.0% (Viscoat), or hyaluronate 3.0% (Vitrax). Temperature over baseline was also determined after 60 seconds. These results were compared with each set of OVD data and with the results in the prior BSS study.
In the eye-bank model, the Legacy machine had a 62% temperature increase from incisional friction and the Sovereign machine had a decrease of 8.6% over results in an artificial anterior chamber. The OVD temperature increases were greater for the Sovereign (P<.001) and followed the same general trend for the Legacy. The least temperature increase was with Amvisc Plus, Healon, and Healon GV; the intermediate increases were with Provisc and Vitrax; and the greatest increases were with Viscoat and Healon5. The OVD findings did not correlate with viscosity or pseudoplasticity.
Incisional friction alone increased heat generation in the Legacy, a stroke-length driven instrument, more than in the Sovereign, a power-driven instrument. Ophthalmic viscosurgical devices are not only a concern due to outflow occlusion but can also add up to 6 times the heat in comparison with BSS. The need to aspirate the OVD before using ultrasound is thus verified.
确定莱格西（爱尔康）和帝视（先进医疗光学公司）超声乳化仪在尸体眼内以及与7种眼科粘弹剂（OVD）联合使用时的热特性。
原位和体外研究。
在置于尸体眼伤口处的套管处记录无阻塞时的温度，并在60秒后测定高于基线的温度。然后将结果与先前在人工房水中使用平衡盐溶液（BSS）的研究结果进行比较。在实验的第二部分，在冲洗和吸引管路阻塞的情况下，在置于充满2.3%透明质酸钠（Healon5）、1.4%透明质酸钠（Healon GV）、1.0%透明质酸钠（Healon）、1.6%透明质酸钠（Amvisc Plus）、1.0%透明质酸钠（Provisc）、3.0%透明质酸钠 - 4.0%硫酸软骨素（Viscoat）或3.0%透明质酸（Vitrax）的人工房水中的套管处记录温度。60秒后也测定高于基线的温度。将这些结果与每组OVD数据以及先前BSS研究的结果进行比较。
在眼库模型中，莱格西仪器因切口摩擦导致温度升高62%，而帝视仪器相比人工前房内的结果温度下降了8.6%。帝视仪器的OVD温度升高幅度更大（P<0.001），莱格西仪器也呈现相同的总体趋势。温度升高最少的是Amvisc Plus、Healon和Healon GV；中等升高的是Provisc和Vitrax；升高最大的是Viscoat和Healon5。OVD的研究结果与粘度或假塑性无关。
仅切口摩擦在莱格西（一种冲程长度驱动的仪器）中产生的热量比在帝视（一种动力驱动的仪器）中更多。眼科粘弹剂不仅因其导致流出阻塞而令人担忧，而且与BSS相比，其产生的热量可能增加多达6倍。因此证实了在使用超声之前需要抽吸OVD。
