高真空设置对超声乳化效率的影响。

Effect of high-vacuum setting on phacoemulsification efficiency.

机构信息

From the Sunderland Eye Infirmary (Ting, Ng, Allen, Steel), the School of Psychology (Rees), University of Sunderland, Sunderland, and the Institute of Genetic Medicine (Steel), Newcastle University, Newcastle upon Tyne, United Kingdom.

出版信息

J Cataract Refract Surg. 2017 Sep;43(9):1135-1139. doi: 10.1016/j.jcrs.2017.09.001.

DOI:10.1016/j.jcrs.2017.09.001

PMID:28991608

Abstract

PURPOSE

To evaluate the effect of a high-vacuum setting versus a low-vacuum setting on the efficiency of phacoemulsification.

SETTING

Sunderland Eye Infirmary, Sunderland, United Kingdom.

DESIGN

Prospective clinical trial.

METHODS

Consecutive patients having cataract surgery in 2014 were recruited. Cataract surgery was performed by 2 experienced surgeons using a phacoemulsification machine with monitored forced infusion. The cataractous lens was split into 2 heminuclei using the stop-and-chop technique; in 1 heminucleus, phacoemulsification and aspiration used a high-vacuum setting (600 mm Hg; treatment group) and in the other heminucleus, a low-vacuum setting (350 mm Hg; control group). The high and low settings were alternated by case per the operating list to reduce surgeon bias. The main outcome measures were cumulative dissipated energy (CDE) and active heminucleus removal time.

RESULTS

One hundred sixty patients (160 eyes) were enrolled in the study, and 158 were included in the analysis. The CDE per heminucleus was significantly lower with the high-vacuum setting than with the low-vacuum setting (mean 2.81 percent-seconds; 95% confidence interval (CI), 2.44-3.21 versus 3.81 percent-seconds; 95% CI, 3.38-4.20; P < .001). The active heminucleus removal time was significantly shorter in the high-vacuum group than the low-vacuum group (mean 27.77 seconds; 95% CI, 25.26-30.19 versus 33.59 seconds; 95% CI, 31.07-35.92; P < .001). The observed differences were independent of the surgeon, patient age and sex, incision size, and nucleus density. No intraoperative complications were observed in either group.

CONCLUSION

A high-vacuum setting improved phacoemulsification efficiency using an active fluidics system and torsional phacoemulsification.

摘要

目的

评估高真空设置与低真空设置对超声乳化效率的影响。

设置

英国桑德兰眼科医院。

设计

前瞻性临床试验。

方法

招募了 2014 年接受白内障手术的连续患者。白内障手术由 2 名经验丰富的外科医生使用带监测强制输注的超声乳化仪进行。使用停切技术将白内障晶状体分为 2 个半核；在 1 个半核中，超声乳化和抽吸使用高真空设置（600mmHg；治疗组），在另 1 个半核中，使用低真空设置（350mmHg；对照组）。根据手术清单，每个病例交替使用高、低设置，以减少外科医生的偏见。主要观察指标为累积耗散能量（CDE）和主动半核去除时间。

结果

该研究共纳入 160 例患者（160 只眼），其中 158 例纳入分析。高真空设置的每个半核 CDE 明显低于低真空设置（平均 2.81 秒；95%置信区间[CI]，2.44-3.21 与 3.81 秒；95%CI，3.38-4.20；P<0.001）。高真空组主动半核去除时间明显短于低真空组（平均 27.77 秒；95%CI，25.26-30.19 与 33.59 秒；95%CI，31.07-35.92；P<0.001）。观察到的差异与外科医生、患者年龄和性别、切口大小和核密度无关。两组均未观察到术中并发症。