From the Department of Ophthalmology & Visual Science (Park, Yum, M.S. Kim, E.C. Kim), College of Medicine, Catholic University of Korea, Seoul, South Korea; the Department of Ophthalmology (Harrison), College of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
J Cataract Refract Surg. 2013 Oct;39(10):1463-9. doi: 10.1016/j.jcrs.2013.04.033. Epub 2013 Jul 31.
To compare the outcomes of coaxial microincision cataract surgery (MICS) performed with 3 phacoemulsification techniques (phaco-chop, divide-and-conquer, and stop-and-chop) according to cataract density.
Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
Prospective randomized clinical trial.
Eyes with nuclear density from grade 2 to 4 were randomly subdivided into 3 groups (phaco-chop, divide-and-conquer, and stop-and-chop). Intraoperative measurements included ultrasound time (UST), mean cumulative dissipated energy (CDE), and balanced salt solution use. Clinical measurements included preoperative and 1 day, 1 month, and 2 month postoperative corrected distance visual acuity, central corneal thickness, and endothelial cell count.
Intraoperative measurements showed significantly less UST, CDE, and balanced salt solution use with the phaco-chop technique than with the divide-and-conquer and stop-and-chop techniques in the grade 4 cataract density group (P<.05). The percentage of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups in the grade 4 cataract density group 2 months after cataract surgery (P<.05).
All 3 techniques may be effective for coaxial MICS in mild and moderate cataracts. However, in eyes with hard cataract having coaxial MICS, the phaco-chop technique can be more effective for lens removal, with less corneal endothelial damage, than the divide-and-conquer and stop-and-chop techniques.
No author has a financial or proprietary interest in any material or method mentioned.
比较 3 种超声乳化技术（超声粉碎法、分块劈核法和停顿劈核法）在白内障密度分级为 2 至 4 级时行同轴微切口白内障超声乳化术（MICS）的效果。
韩国首尔天主教大学附属顺天圣母医院。
前瞻性随机临床试验。
将核密度分级为 2 至 4 级的眼随机分为 3 组（超声粉碎法组、分块劈核法组和停顿劈核法组）。术中测量指标包括超声时间（UST）、平均累积消散能量（CDE）和平衡盐溶液使用量。临床测量指标包括术前及术后 1 天、1 个月和 2 个月的矫正远视力、中央角膜厚度和内皮细胞计数。
术中测量指标显示，在核密度分级为 4 级的白内障眼中，超声粉碎法组的 UST、CDE 和平衡盐溶液使用量明显少于分块劈核法组和停顿劈核法组（P<.05）。白内障手术后 2 个月，超声粉碎法组的内皮细胞丢失百分比明显低于分块劈核法组和停顿劈核法组（P<.05）。
在轻、中度白内障中行同轴 MICS 时，3 种技术都可能有效。然而，在硬核白内障患者中行同轴 MICS 时，与分块劈核法和停顿劈核法相比，超声粉碎法在去除晶状体方面更有效，对角膜内皮的损伤更小。
无作者存在任何材料或方法相关的经济或所有权利益。
