双眼微切口与同轴小切口白内障手术治疗复杂病例的比较。

Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases.

机构信息

Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany.

出版信息

J Cataract Refract Surg. 2010 Jan;36(1):66-72. doi: 10.1016/j.jcrs.2009.07.036.

DOI:10.1016/j.jcrs.2009.07.036

PMID:20117707

Abstract

PURPOSE

To evaluate and compare the results of biaxial microincision and coaxial small-incision surgery in patients with cataract with coexisting exfoliation syndrome, uveitis, anterior or posterior synechias, phacodonesis, or previous intraocular surgery over an 8-week follow-up.

SETTING

Department of Ophthalmology, Mainz University, Mainz, Germany.

METHODS

Eyes were prospectively assigned (1:1) to have biaxial microincision (<1.5 mm) phacoemulsification or coaxial small-incision (2.8 mm) phacoemulsification using pulsed ultrasound energy (Sovereign WhiteStar) with variable duty cycles followed by implantation of a microincision intraocular lens. Intraoperative and postoperative complications, corrected distance visual acuity (CDVA), laser flare photometry values, effective phacoemulsification time (EPT), and endothelial cell count (ECC) were evaluated.

RESULTS

The study enrolled 94 eyes. There were no statistically significant differences between the techniques in intraoperative or postoperative complications. The most frequent postoperative complications were corneal edema surrounding the incision (40%, biaxial group; 35%, coaxial group), pupil distortion (3% versus 7%), and fibrin exudation (3% versus 3%). No other postoperative complications occurred. The median EPT was statistically significantly shorter (1.34 seconds versus 5.4 seconds) and the median phaco power significantly lower (3.3% versus 12.9%) in the biaxial group than in the coaxial group (P<.001). There were no differences between groups in CDVA, laser flare photometry values, or ECC.

CONCLUSIONS

The EPT was shorter and the mean phaco power lower with biaxial phacoemulsification, perhaps because of better access of the phaco handpiece for grooving the nucleus with this technique. The 2 techniques were comparable in intraoperative and postoperative complications.

FINANCIAL DISCLOSURE

No other author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

评估并比较白内障合并剥脱综合征、葡萄膜炎、前后粘连、晶状体溶解性青光眼或既往眼内手术的患者行双轴微切口和同轴小切口手术的 8 周随访结果。

设置

德国美因茨大学眼科。

方法

前瞻性将双眼（1:1）随机分配行双轴微切口（<1.5mm）超声乳化白内障吸除术或同轴小切口（2.8mm）超声乳化白内障吸除术（采用 Sovereign WhiteStar 超声乳化仪，应用可变占空比脉冲能量），并植入微切口人工晶状体。评估术中及术后并发症、最佳矫正视力（CDVA）、激光散射光测量值、有效超声乳化时间（EPT）和内皮细胞计数（ECC）。

结果

本研究共纳入 94 只眼。两种手术技术的术中或术后并发症无统计学差异。最常见的术后并发症是切口周围角膜水肿（双轴组 40%，同轴组 35%）、瞳孔变形（3%比 7%）和纤维蛋白渗出（3%比 3%）。无其他术后并发症发生。双轴组的 EPT 中位数显著更短（1.34s 比 5.4s），超声能量中位数显著更低（3.3%比 12.9%）（P<.001）。两组在 CDVA、激光散射光测量值或 ECC 方面无差异。