Liu Yizhi, Zeng Mingbing, Liu Xialin, Luo Lixia, Yuan Zhaohui, Xia Yuanlin, Zeng Yangfa
Zhongshan Ophthalmic Center, Sun-Yat-Sen University, Guangzhou, China.
J Cataract Refract Surg. 2007 Feb;33(2):287-92. doi: 10.1016/j.jcrs.2006.10.044.
To compare the intraoperative and short-term postoperative outcomes of cataract surgery performed with torsional mode and conventional ultrasound mode using the Infiniti Vision System (Alcon Laboratories).
Cataract Service, Zhongshan Ophthalmic Center, Sun-Yat-Sen University, Guangzhou, China.
In this randomized comparative study, 525 eyes were assigned to phacoemulsification by torsional mode or conventional ultrasound (US) mode. The surgery was performed by an experienced surgeon, and the outcomes were evaluated by an examiner who was masked to treatment assignments. Primary outcome measures were US time (UST), cumulative dissipated energy (CDE), and surgical complications. Patients were seen 1, 7, and 30 days after surgery. Postoperative outcome measures were the final best corrected visual acuity (BCVA) and the change in corneal clarity, central corneal thickness (CCT), and endothelial cell count.
The US group had 262 eyes and the torsional group, 263 eyes. All patients completed the follow-up visits. In the eyes with nucleus density grades of 1, 2, 3, and 4, the mean UST was 10.25 seconds +/- 7.4 (SD), 25.14 +/- 5.5 seconds, 36.45 +/- 8.3 seconds, and 61.44 +/- 17.8, respectively, in the US group and 8.32 +/- 6.8 seconds, 18.45 +/- 7.2 seconds, 29.48 +/- 12.4 seconds, and 48.39 +/- 20.3 seconds, respectively, in the torsional group (P<.001); the mean CDE was 1.25 +/- 0.5, 4.18 +/- 1.2, 8.59 +/- 6.5, and 16.51 +/- 9.6, respectively, in the US group and 0.94 +/- 0.3, 3.13 +/- 2.7, 7.47 +/- 12.6, and 14.08 +/- 8.3, respectively, in the torsional group (P<.001). At 1 day and 7 days, the mean BCVA was 0.23 +/- 0.12 logMAR and 0.00 +/- 0.10 logMAR, respectively, in the US group and 0.18 +/- 0.11 logMAR and -0.08 +/- 0.05 logMAR, respectively, in the torsional group (P<.001). At 30 days, the mean BCVA was -0.10 +/- 0.07 logMAR and -0.12 +/- 0.06 logMAR in the US group and the torsional group, respectively (P>.01). At 1 day and 7 days, the mean CCT was 625 +/- 80 microm and 568 +/- 37 microm, respectively, in the US group and 601 +/- 35 microm and 559 +/- 40 microm, respectively, in the torsional group (P<.001). At 30 days, the mean CCT was 531 +/- 30 microm in the US group and 529 +/- 39 microm in the torsional group (P>.01). At 7 days and 30 days, the mean central corneal endothelial cell count was 2135 +/- 858 cells/mm(2) and 2084 +/- 527 cells/mm(2), respectively, in the US group and 2004 +/- 656 cells/mm(2) and 1953 +/- 615 cells/mm(2), respectively, in the torsional group (P<.001).
The torsional mode may provide more effective lens removal with a lower level of phacoemulsification time and energy.
比较使用Infiniti视觉系统（爱尔康实验室）的扭转模式和传统超声模式进行白内障手术的术中及术后短期效果。
中国广州中山大学中山眼科中心白内障科。
在这项随机对照研究中，525只眼睛被分配接受扭转模式或传统超声（US）模式的超声乳化手术。手术由一名经验丰富的外科医生进行，结果由一名对治疗分组不知情的检查者评估。主要观察指标为超声时间（UST）、累积消散能量（CDE）和手术并发症。术后1天、7天和30天对患者进行检查。术后观察指标为最终最佳矫正视力（BCVA）以及角膜清晰度、中央角膜厚度（CCT）和内皮细胞计数的变化。
US组有262只眼，扭转组有263只眼。所有患者均完成随访。在核密度等级为1、2、3和4的眼中，US组的平均UST分别为10.25秒±7.4（标准差）、25.14±5.5秒、36.45±8.3秒和61.44±17.8秒，扭转组分别为8.32±6.8秒、18.45±7.2秒、29.48±12.4秒和48.39±20.3秒（P<.001）；US组的平均CDE分别为1.25±0.5、4.18±1.2、8.59±6.5和16.51±9.6，扭转组分别为0.94±0.3、3.13±2.7、7.47±12.6和14.08±8.3（P<.001）。术后1天和7天，US组的平均BCVA分别为0.23±0.12 logMAR和0.00±0.10 logMAR，扭转组分别为0.18±0.11 logMAR和 -0.08±0.05 logMAR（P<.001）。术后30天，US组和扭转组的平均BCVA分别为 -0.10±0.07 logMAR和 -0.12±0.06 logMAR（P>.01）。术后1天和7天，US组的平均CCT分别为625±80微米和568±37微米，扭转组分别为601±35微米和559±40微米（P<.001）。术后30天，US组的平均CCT为531±30微米，扭转组为529±39微米（P>.01）。术后7天和30天，US组的平均中央角膜内皮细胞计数分别为2135±858个细胞/mm²和2084±527个细胞/mm²，扭转组分别为2004±656个细胞/mm²和1953±615个细胞/mm²（P<.001）。
扭转模式可能以较低的超声乳化时间和能量水平更有效地摘除晶状体。
