同轴微小切口白内障手术中超声扭转和纵向模式下体内伤口及表面温度
Wound and surface temperatures in vivo in torsional and longitudinal modalities of ultrasound in coaxial microincisional cataract surgery.
作者信息
Nair Swapna, Nair Ramachandran Unnikrishnan
机构信息
Department of Cataract and Refractive Surgery.
Department of Vitreoretinal Services, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India.
出版信息
Clin Ophthalmol. 2017 Jan 27;11:249-255. doi: 10.2147/OPTH.S123222. eCollection 2017.
BACKGROUND
To study phacoemulsification probe shaft/wound and corneal surface/tip temperatures in vivo during longitudinal, torsional and combined phacoemulsification modes and their relationship to machine parameters.
DESIGN
This was a prospective study at Chaithanya Eye Hospital and Research Institute, Trivandrum, India (tertiary).
PARTICIPANTS
Twenty-two eyes of 22 patients were randomized into six groups depending on the grade of nuclear sclerosis (NS) and the type of ultrasound used: Group 1, torsional in NS2; Group 2, torsional in NS3; Group 3, torsional with intermittent longitudinal in NS2; Group 4, torsional with intermittent longitudinal in NS3; Group 5, longitudinal in NS2; Group 6, longitudinal in NS3.
METHODS
Patients underwent phacoemulsification by torsional, longitudinal or combined modalities. A thermal camera was used to measure phaco probe temperatures.
MAIN OUTCOME MEASURES
The mean probe shaft and tip temperatures were documented for different ultrasound modalities.
RESULTS
The mean shaft and tip temperatures were: Group 1, 29.22°C±0.71°C and 28.4°C±0.88°C; Group 2, 32.12°C±0.62°C and 31.88°C±0.84°C; Group 3, 30.25°C±0.71°C and 29.35°C±0.62°C; Group 4, 31.95°C±0.65°C and 32.01°C±1.31°C; Group 5, 23°C and 27.6°C and Group 6, 23°C and 29.68°C, respectively. In all groups using longitudinal ultrasound, the phaco tip surface temperatures were higher than the shaft temperatures, except in Group 3. Shaft temperatures were higher than tip temperatures in cases using torsional phaco, except in Group 4. The mean temperature difference between groups was significant only for shaft temperatures (=0.001). On thermal imaging, for torsional phaco, the rise in temperature of the probe from shaft to tip was dependent on the amplitude of ultrasound applied (=0.009).
CONCLUSION
The shaft temperatures were higher than over the phaco tip during torsional phacoemulsification.
背景
研究在纵向、扭转及联合超声乳化模式下，体内超声乳化探头杆部/切口与角膜表面/探头尖端的温度，以及它们与机器参数的关系。
设计
这是一项在印度特里凡得琅Chaitanya眼科医院及研究所（三级医疗机构）开展的前瞻性研究。
参与者
22例患者的22只眼根据核硬化程度（NS）和使用的超声类型随机分为六组：第1组，NS2级，扭转模式；第2组，NS3级，扭转模式；第3组，NS2级，扭转联合间歇性纵向模式；第4组，NS3级，扭转联合间歇性纵向模式；第5组，NS2级，纵向模式；第6组，NS3级，纵向模式。
方法
患者接受扭转、纵向或联合模式的超声乳化手术。使用热成像仪测量超声乳化探头的温度。
主要观察指标
记录不同超声模式下探头杆部和尖端的平均温度。
结果
杆部和尖端的平均温度分别为：第1组，29.22°C±0.71°C和28.4°C±0.88°C；第2组，32.12°C±0.62°C和31.88°C±0.84°C；第3组，30.25°C±0.71°C和29.35°C±0.62°C；第4组，31.95°C±0.65°C和32.01°C±1.31°C；第5组，23°C和27.6°C；第6组，23°C和29.68°C。在所有使用纵向超声的组中，除第3组外，超声乳化探头尖端表面温度均高于杆部温度。在使用扭转超声乳化的病例中，除第4组外，杆部温度高于尖端温度。各组之间的平均温度差异仅在杆部温度方面具有显著性（P = 0.001）。在热成像中，对于扭转超声乳化，探头从杆部到尖端的温度升高取决于所施加超声的振幅（P = 0.009）。
结论
在扭转超声乳化过程中，探头杆部温度高于超声乳化探头尖端的温度。
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