From the Tasmanian Eye Institute (Hooshmand, Abell, Allen, Vote) and the Rural Clinical School (Allen), University of Tasmania, Launceston, Tasmania, and the Royal Victorian Eye and Ear Hospital (Abell), Melbourne, Victoria, Australia.
From the Tasmanian Eye Institute (Hooshmand, Abell, Allen, Vote) and the Rural Clinical School (Allen), University of Tasmania, Launceston, Tasmania, and the Royal Victorian Eye and Ear Hospital (Abell), Melbourne, Victoria, Australia.
J Cataract Refract Surg. 2018 Mar;44(3):355-361. doi: 10.1016/j.jcrs.2017.12.027.
To assess the clinical safety and performance of a new thermal capsulotomy device in patients having cataract surgery.
Launceston Eye Institute, Launceston, Tasmania, Australia.
Prospective case series.
This single-surgeon consecutive series comprised eyes having capsulotomy with a precision pulse capsulotomy (PPC) device (Zepto). Baseline demographic information and preoperative, intraoperative, and early postoperative outcomes, including complications, intraocular pressure (IOP), flare photometry, corneal and retinal thickness, and specular microscopy were collected and analyzed. Outcomes included PPC performance, intraoperative complications, effective phacoemulsification time, IOP, postoperative inflammation, corneal edema, endothelial cell density, functional evaluation of the corneal endothelium, retinal thickness, cost-effectiveness, and early postoperative visual acuity.
The study evaluated 100 eyes. Complete free-floating capsulotomy was achieved in 70 eyes (72%). Focal attachments were identified in 17 eyes (18%) and broad attachments in 10 eyes (10%). Intended PPC capsulotomy failed in 3 eyes due to operator or device error. Anterior capsule tears occurred in 4 eyes (4%); otherwise, there were no significant safety signals in the early postoperative period. There was no evidence of a learning curve effect; however, use of a dispersive ophthalmic viscosurgical device (OVD) is postulated as influencing capsulotomy completeness.
The PPC device created round, reproducible, appropriately sized capsulotomies in 72% of eyes. The incidence of incomplete capsulotomy and radial tear rate was high and was possibly associated with the use of a dispersive OVD.
评估一种新型热囊膜切开设备在白内障手术患者中的临床安全性和性能。
澳大利亚塔斯马尼亚州朗塞斯顿眼研究所。
前瞻性病例系列。
本单外科医生连续系列研究纳入了进行囊膜切开术的患者，使用的是精准脉冲囊膜切开（PPC）设备（Zepto）。收集并分析了基线人口统计学信息以及术前、术中、术后早期的结果，包括并发症、眼内压（IOP）、前房闪烁光度测定、角膜和视网膜厚度以及共焦显微镜。研究结果包括 PPC 性能、术中并发症、有效超声乳化时间、IOP、术后炎症、角膜水肿、内皮细胞密度、角膜内皮功能评估、视网膜厚度、成本效益和术后早期视力。
本研究评估了 100 只眼。70 只眼（72%）实现了完整的游离囊膜切开术。17 只眼（18%）存在局灶性粘连，10 只眼（10%）存在广泛粘连。由于操作者或设备错误，3 只眼的预期 PPC 囊膜切开术失败。4 只眼（4%）发生了前囊膜撕裂，否则在术后早期没有明显的安全信号。没有证据表明存在学习曲线效应；然而，使用分散性眼用粘弹剂（OVD）被认为会影响囊膜切开术的完整性。
PPC 设备在 72%的眼中成功完成了圆形、可重复、大小适当的囊膜切开术。不完全囊膜切开术和放射状撕裂的发生率较高，可能与使用分散性 OVD 有关。
