John A. Moran Eye Center, University of Utah, Salt Lake City, USA.
John A. Moran Eye Center, University of Utah, Salt Lake City, USA.
J Cataract Refract Surg. 2019 Nov;45(11):1660-1664. doi: 10.1016/j.jcrs.2019.06.016. Epub 2019 Oct 1.
To evaluate the use of a new hybrid phacoemulsification tip made with a high strength polymer overmold designed to prevent posterior capsule rupture (PCR) compared with a metal tip.
John A. Moran Eye Center, University of Utah, USA.
Experimental study.
This ex vivo crossover study compared a new phacoemulsification tip to a metal tip. After a preliminary experiment applying the tips to the posterior capsule with the bevel down, 10 phakic cadaver eyes were prepared using the Miyake-Apple technique, after which each tip was tested in a series. After lensectomy, the posterior capsule was subjected to direct contact from the tip with the bevel up. The vacuum limit was set to 150 mm Hg, and the aspiration flow rate to 30 cc/min, after which the torsional power was increased by increments of 5% up to a maximum amplitude of 60%. The primary endpoint was the torsional power required to produce PCR.
Vacuum alone did not cause PCR with either tip. All tests showed that a higher torsional power was required for PCR with the hybrid tip. With the bevel directed upward, the hybrid tip required higher torsional power before PCR than the metal tip (55% ± 10.0% [SD] versus 15% ± 4.1%, respectively) (P value < .001). This indicates that there is a lower likelihood for PCR with the hybrid tip.
The hybrid tip used in this study can be an effective means of preventing surgical complications such as PCR. This tip would be useful for experienced surgeons as well as for those who are in training.
评估一种新的混合式超声乳化针头的使用效果，该针头采用高强度聚合物覆盖模制成，旨在防止后囊破裂（PCR），与金属针头相比。
美国犹他大学约翰·A·莫兰眼中心。
实验研究。
本体外交叉研究比较了一种新的超声乳化针头和金属针头。在初步实验中，将针头的斜面朝下应用于后囊后，使用 Miyake-Apple 技术制备了 10 个有晶状体的尸体眼球，然后用一系列方法测试了每个针头。晶状体切除术后，将后囊直接暴露于针头的斜面朝上。将真空限制设置为 150 毫米汞柱，抽吸流量设置为 30 立方厘米/分钟，然后将扭转功率增加 5%，直到达到最大幅度 60%。主要终点是产生 PCR 所需的扭转功率。
单独使用真空不会导致任何一个针头产生 PCR。所有测试均表明，杂交针头产生 PCR 需要更高的扭转功率。当斜面朝上时，杂交针头在 PCR 之前需要比金属针头更高的扭转功率（分别为 55%±10.0%[标准差]和 15%±4.1%）（P 值<.001）。这表明杂交针头发生 PCR 的可能性较低。
本研究中使用的杂交针头可以有效预防后囊破裂等手术并发症。这种针头对于经验丰富的外科医生和培训中的医生都很有用。
