Li Panpan, Tu Yuanyuan, Chen Xiang, Song Yu, Guan Huaijin
Department of Ophthalmology, Nantong City No. 1 People's Hospital and Second Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China.
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China.
J Ophthalmol. 2019 Sep 15;2019:7182324. doi: 10.1155/2019/7182324. eCollection 2019.
To compare the efficiency and safety of steep-axis one-handed phacoemulsification with steep-axis two-handed phacoemulsification.
Patients with cataracts underwent steep-axis one-handed (steep-axis one-handed group) or steep-axis two-handed (steep-axis two-handed group) phacoemulsification with a 2.4 mm clear corneal incision (CCI) under the guidance of the Verion Image-Guided System. Intraoperative phacoparameters, such as visual acuity, surgically induced astigmatism (SIA), total corneal astigmatism (TCA), angle of error (AE), corneal volume (CV), and corneal endothelial cells, were compared.
There were no significant differences in the intraoperative phacoparameters between the two groups. The visual outcomes were significantly better in the steep-axis one-handed group than in the two-handed group at 1 week postoperatively (all < 0.05) but not at 1 month and 3 months postoperatively. TCAs were significantly decreased in both groups at 1 and 3 months postoperatively (all < 0.05). There were no significant differences at any follow-up points in both groups (all < 0.001). At 3 months postoperatively, the SIA was 0.95 ± 0.44 D in the steep-axis one-handed group and 1.01 ± 0.50 D in the steep-axis two-handed group; there was no significant difference between the groups. The AE was 39.45 ± 26.53° in the steep-axis one-handed group and 49.75° ± 26.23° in the steep-axis two-handed group, which were significantly different (=0.005). Endothelial cell loss was significantly lower in the steep-axis one-handed group than that in the steep-axis two-handed group at all follow-up points (all < 0.05).
Both the steep-axis one-handed and the steep-axis two-handed techniques could significantly decrease TCA. Compared with the steep-axis two-handed technique, the steep-axis one-handed technique has the advantage of decreasing the AE and reducing trauma to the cornea in soft-to-moderate nuclei.
比较陡轴单手超声乳化术与陡轴双手超声乳化术的效率和安全性。
白内障患者在Verion图像引导系统的引导下，通过2.4毫米透明角膜切口（CCI）接受陡轴单手（陡轴单手组）或陡轴双手（陡轴双手组）超声乳化术。比较术中的超声参数，如视力、手术源性散光（SIA）、总角膜散光（TCA）、误差角度（AE）、角膜体积（CV）和角膜内皮细胞。
两组术中超声参数无显著差异。术后1周时，陡轴单手组的视觉效果明显优于双手组（均P<0.05），但术后1个月和3个月时无差异。两组术后1个月和3个月时TCA均显著降低（均P<0.05）。两组在任何随访点均无显著差异（均P<0.001）。术后3个月时，陡轴单手组的SIA为0.95±0.44D，陡轴双手组为1.01±0.50D；两组间无显著差异。陡轴单手组的AE为39.45±26.53°，陡轴双手组为49.75°±26.23°，差异有统计学意义（P=0.005）。在所有随访点，陡轴单手组的内皮细胞损失均显著低于陡轴双手组（均P<0.05）。
陡轴单手和陡轴双手技术均可显著降低TCA。与陡轴双手技术相比，陡轴单手技术在软至中度核的情况下具有降低AE和减少角膜创伤的优势。
