Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ophthalmologica. 2012;227(1):55-9. doi: 10.1159/000329599. Epub 2011 Aug 10.
To evaluate the effect of torsional handpiece incision size on phacodynamics and endothelial cell loss (ECL) in cataract surgery.
Prospective, observer-masked study at the Department of Ophthalmology and Visual Science, Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
This study was conducted on 60 eyes of 60 patients who underwent phacoemulsification.
Cataract surgery was performed on 28 eyes using a 0.9-mm micro 45-degree Kelman ABS (aspiration bypass system) tip through a 2.8-mm standard incision, and on 32 eyes using a 0.9-mm mini-flared 45-degree Kelman ABS tip through a 2.2-mm microcoaxial incision. As main outcome measures, intraoperative phacodynamics (cumulative dissipated energy, CDE, and balanced salt solution, BSS, use), central corneal thickness (CCT) and endothelial cell count (ECC) were investigated.
The CDE was lower in the microcoaxial incision (2.2-mm) group than in the standard incision (2.8-mm) group (p = 0.038). The ECC loss at 6 months was significantly lower in the microcoaxial incision group than in the standard incision group (p = 0.048). There were no differences in BSS use or CCT between the two groups.
Torsional ultrasound phacoemulsification using microcoaxial incision with a mini-flared tip resulted in less energy use and less ECL compared with standard incision with a micro tip.
评估扭转式手机切口大小对白内障手术中超声乳化的影响和内皮细胞损失（ECL）。
在韩国首尔天主教大学圣玛丽医院眼科和视觉科学系进行的前瞻性、观察者盲法研究。
这项研究共纳入 60 例 60 只眼接受白内障超声乳化术的患者。
28 只眼采用 0.9mm 微 45 度 Kelman ABS（抽吸旁路系统）尖端通过 2.8mm 标准切口进行白内障手术，32 只眼采用 0.9mm 迷你喇叭口 45 度 Kelman ABS 尖端通过 2.2mm 微同轴切口进行白内障手术。主要观察指标为术中超声乳化的动力（累积消散能量 CDE 和平衡盐溶液 BSS 的使用）、中央角膜厚度（CCT）和内皮细胞计数（ECC）。
微同轴切口（2.2mm）组的 CDE 低于标准切口（2.8mm）组（p=0.038）。微同轴切口组 6 个月时 ECC 丢失率明显低于标准切口组（p=0.048）。两组间 BSS 使用量或 CCT 无差异。
与微切口微尖端相比，使用迷你喇叭口微同轴切口的扭转式超声乳化可减少能量使用和 ECL。
