Davison James A
Department of Ophthalmology and Visual Science, University of Utah, Salt Lake City, Utah, USA.
J Cataract Refract Surg. 2008 Jun;34(6):986-90. doi: 10.1016/j.jcrs.2008.02.029.
To compare surgeon-generated tip travel and surgical time of longitudinal and torsional phacoemulsification with straight and angled tips.
Private practice, Marshalltown, Iowa, USA.
The study analyzed surgical videos of 46 phacoemulsification cases performed by 1 surgeon. Based on the tip and type of ultrasound (US) used, the cases were prospectively assigned to 1 of 4 groups and operated on consecutively: straight tip/longitudinal US, straight tip/torsional US, angled tip/longitudinal US, and angled tip/torsional US. Digital Video Measurement System software (Caltex Scientific) was used to measure the phacoemulsification tip's travel during the removal of all 4 nuclear quadrants and the removal of quadrants 2 and 3 (2+3) and to determine surgical time. The cumulative travel distance and surgical time of the 4 groups were compared using analysis of variance.
The angled tip/torsional US combination reduced tip travel by more than 40% compared with the straight tip/longitudinal US when comparing travel to aspirate all 4 quadrants and quadrants 2+3. Surgical time in the removal of all 4 quadrants and quadrants 2+3 was significantly lower in the angled tip/torsional US group than in the other groups.
Torsional phacoemulsification using an angled tip required less surgeon-generated tip travel and less time, suggesting that nuclear material may be more efficiently approximated to and aspirated through the tip aperture throughout the phacoemulsification process. Shorter cumulative tip travel and less procedure time imply increased nuclear followability, fewer reacquisition movements, and increased phacoemulsification efficiency and safety.
比较使用直头和弯头的纵向及扭转式超声乳化手术中术者操作的探头移动距离和手术时间。
美国爱荷华州马歇尔敦的私人诊所。
本研究分析了由1名外科医生进行的46例超声乳化手术的视频。根据所使用的探头及超声类型，这些病例被前瞻性地分为4组中的1组并连续进行手术：直头/纵向超声、直头/扭转式超声、弯头/纵向超声、弯头/扭转式超声。使用数字视频测量系统软件（Caltex Scientific）测量在摘除所有4个核象限以及摘除第2和第3象限（2 + 3）过程中超声乳化探头的移动距离，并确定手术时间。使用方差分析比较4组的累积移动距离和手术时间。
在比较吸取所有4个象限以及2 + 3象限的移动距离时，弯头/扭转式超声组合与直头/纵向超声相比，探头移动距离减少了40%以上。在摘除所有4个象限以及2 + 3象限的过程中，弯头/扭转式超声组的手术时间显著低于其他组。
使用弯头的扭转式超声乳化术所需的术者操作探头移动距离更短，时间更少，这表明在整个超声乳化过程中，核物质可能能更有效地靠近并通过探头开口被吸出。累积探头移动距离更短以及手术时间更少意味着核物质跟随性增强、重新获取动作减少，以及超声乳化效率和安全性提高。
